Journal articles: 'Implication du patient'

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Bertoncini, Fabio, Dino Stefano Di Massimo, and Claudia Gatta. "Sepsis: implication for nursing." Italian Journal of Medicine 10, no. 4 (December 15, 2016): 360. http://dx.doi.org/10.4081/itjm.2016.801.

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Sepsis is a serious health problem that is off worldwide interest; it is associated with a high mortality rate despite continuing improvements in infection management and the awareness of population is still poor despite its importance. Direct interventions to achieve the goal of clinician, like reduction of mortality, pass through the resuscitation and antibiotics but their effectiveness depends on the early recognition of symptoms and therefore the septic state. The nursing role is crucial both for the early recognition of the disease state, as well as to treat the patient with professionalism and promptness and to provide appropriate assistance to the kind of complexity that creates this pathological state: to achieve these aims, recommendations and bundles were developed to guide clinical nurses in septic patients’ care.

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S, Rawat. "Implication of Ayurveda in the Management of Apasmara (Epilepsy) – Case Study." Journal of Natural & Ayurvedic Medicine 7, no. 1 (January 4, 2023): 1–5. http://dx.doi.org/10.23880/jonam-16000386.

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Epilepsy affects 1% of the world’s population a most common serious disorder of the brain, greatly impacting on the quality of life of affected individuals. In Ayurveda, the similar presentation is named as Apasmara has been explained with its aetiology, diagnosis and management. Imbalance in the three Doshas Vata, Pitta, Kapha singly or all of them together can cause Apasmara. Those aggravated Doshas get accumulated in Hridya and produce the features based upon Doshika predominance which cause illusion of the mind and visual hallucination and seizures (tonic spasms and clonic jerks) often it is presented with outwarding tongue, deviation of eyes, dribbling of saliva with froth, tonic and clonic movements of limbs. Even though medical world claims of the advancements in the management of Apasmara drugs don’t work as they expect. The present Anti-epileptic drugs medication has so many drawbacks like adverse drug interaction and teratogenicity, cognitive impairment to an extent is also seen in some patients with epilepsy. An 18-year male patient arrived to the OPD and complained of seizure attack from last 6 years. The patient sought out ayurvedic treatment because he had tried numerous allopathic treatments but did not get significant result. With the Ayurvedic treatment, remarkable changes in the symptoms of Epilepsy were seen.

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Xi, Yiyun, Youjia Yin, and Jinquan Zhang. "Delay Discounting Clinical Implication for BED Treatment." Journal of Education, Humanities and Social Sciences 8 (February 7, 2023): 2531–36. http://dx.doi.org/10.54097/ehss.v8i.5026.

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Binge Eating Disorder (BED), a common eating disorder appearing in people in their late 20s, shows a symptom of consuming an unusual amount of food in a short amount of time. BED is usually defined as repeated episodes of binge eating accompanied by feelings of loss of control and distress, but unlike bulimia nervosa (BN), BED does not involve inappropriate compensatory behaviors to maintain weight, such as excessive dieting or exercise. Research has already begun to look at the neural mechanisms of overeating. This paper focuses on the finding of a new treatment for BED patient without the usage of medication. The proposed methods are using stimuli and therapy to regulate the focus of the patients’ eating behavior, self-evaluation, and social behaviors. The results obtained from the research included the effect of delay discounting of each method of treatment on the patient. The findings indicated that reducing delay discounting has clinical implications for the treatment of BED.

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Bansode-Gokhe, Seema, Rakesh Waghmare, and Ratnerdra Ratnendra. "Diabetes mellitus: Implication in rural area of Thane district, India." Journal of Social Health and Diabetes 03, no. 01 (June 2015): 039–42. http://dx.doi.org/10.4103/2321-0656.140887.

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Abstract Context: Diabetes mellitus along with its complications contribute a significant amount of burden on the society. Lack of awareness has resulted in an increased number of diabetics over the years. Aims: To study the sociodemographic status, complication profile and perception of diabetic patients regarding their illness. Settings and Design: Cross sectional center based study done on 110 type 2 diabetic patients over a period of 5 months at rural health training center. Materials and Methods: Universal sampling technique was used. All old and newly diagnosed diabetic patients were interviewed by Face to Face interview method. Statistical Analysis: Descriptive statistics for sociodemographic factors and morbidity; cross tabulation by using test of significance to find association between different variables were used. Results: 50% patients were illiterate, 91.82% were married and 44.5% were farmers. The perception of self-health was reported GOOD on Stanford patient education research center questionnaire scale in 62.7% patients; these responses were significantly associated with males. 61.81% patient had symptoms of coronary heart disease (CHD). 87.3%, 59.1%, and 58.2% patient had symptoms of neuropathy, nephropathy and retinopathy respectively. Out of 61 patients who were aware of complications only 1/10th were aware with the fact that diabetes can affect eye and heart. Conclusions: Almost half patients were unaware that disease is associated with complications and in remaining halves awareness was negligible for neuropathy and nephropathy. In contrast around 2/3rd patients had symptoms of CHD, nephropathy and retinopathy.

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Miligy, Dawlat A. "Laboratory errors and patient safety." International Journal of Health Care Quality Assurance 28, no. 1 (February 9, 2015): 2–10. http://dx.doi.org/10.1108/ijhcqa-10-2008-0098.

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Purpose – Laboratory data are extensively used in medical practice; consequently, laboratory errors have a tremendous impact on patient safety. Therefore, programs designed to identify and reduce laboratory errors, as well as, setting specific strategies are required to minimize these errors and improve patient safety. The purpose of this paper is to identify part of the commonly encountered laboratory errors throughout our practice in laboratory work, their hazards on patient health care and some measures and recommendations to minimize or to eliminate these errors. Design/methodology/approach – Recording the encountered laboratory errors during May 2008 and their statistical evaluation (using simple percent distribution) have been done in the department of laboratory of one of the private hospitals in Egypt. Errors have been classified according to the laboratory phases and according to their implication on patient health. Findings – Data obtained out of 1,600 testing procedure revealed that the total number of encountered errors is 14 tests (0.87 percent of total testing procedures). Most of the encountered errors lay in the pre- and post-analytic phases of testing cycle (representing 35.7 and 50 percent, respectively, of total errors). While the number of test errors encountered in the analytic phase represented only 14.3 percent of total errors. About 85.7 percent of total errors were of non-significant implication on patients health being detected before test reports have been submitted to the patients. On the other hand, the number of test errors that have been already submitted to patients and reach the physician represented 14.3 percent of total errors. Only 7.1 percent of the errors could have an impact on patient diagnosis. Practical implications – The findings of this study were concomitant with those published from the USA and other countries. This proves that laboratory problems are universal and need general standardization and bench marking measures. Originality/value – Original being the first data published from Arabic countries that evaluated the encountered laboratory errors and launch the great need for universal standardization and bench marking measures to control the laboratory work.

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Freixas Sala, Núria, Olga Monistrol Ruano, Jordi Espuñes Vendrell, Montserrat Sallés Creus, Mónica Gallardo González, Carme Ramón Cantón, María José Bueno Domínguez, Montserrat Llinas Vidal, and María Antonia Campo Osaba. "Patient safety and nursing implication: Survey in Catalan hospitals." Enfermería Clínica (English Edition) 27, no. 2 (March 2017): 94–100. http://dx.doi.org/10.1016/j.enfcle.2016.03.001.

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Josan, Lucian, Alina Ormenisan, Elina Teodorescu, Delia Daragiu, and Mariana Pacurar. "Patient’s interest towards interconnection and social implication with trainer doctor model." Romanian Journal of Stomatology 68, no. 4 (December 31, 2022): 169–77. http://dx.doi.org/10.37897/rjs.2022.4.3.

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OED and the dictionary of the world defines a "doctor" 700 years ago and today as a "teacher". The root word for the word doctor derives from Latin "docere", which means "to teach". The doctor contributes to educating patients about a number of medical conditions (the patient is experiencing a number of diseases). In essence, the doctor has the role as a teacher. Doctor-patient interaction works on relational models. The physician-trainer paradigm is required to be introduced to improve patient status. The physician-trainer model is a participatory model that results in achieving the patient's well-being and improving his/her health; the physician uses his or her capacity as a trainer, that is, he has the ability to form and instill adequate conduct for each patient. In this paper, besides highlighting the appetence for the relationship between the trainer and the patient, we tried to quantify the patient's acceptance of the treatment with/without continuous monitoring of the disease (chronic diseases), the degree of reasonableness in accepting the therapeutic behavior, and lastly how the individual feels the change of his status in the patient. The study was conducted on a total of 217 subjects (125 female subjects and 92 male subjects). The applied questionnaire contained 18 questions, structured to help us confirm or not the study's objectives. The results obtained will show us the level of appetite for the trainer-patient relationship.

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Bansal, Rimpi, Puneet Kaur, Jatin Sarin, Anureet Kaur, and Akshita Sarin. "Incidence and Prognostic Implication of Bone Marrow Involvement in Hodgkin’s Lymphoma." Annals of Pathology and Laboratory Medicine 8, no. 11 (December 2, 2021): A239–242. http://dx.doi.org/10.21276/apalm.3010.

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Introduction- : Conducting Bone marrow examination in a Hodgkin's Lymphoma (HL) patient at the time of diagnosis is done routinely to determine the stage of the disease. The aim of this study was to analyze the incidence and prognosis of bone marrow involvement in patients with Hodgkins lymphoma, retrospectively. Materials and Patients: Ten patients of Hodgkins lymphoma were incorporated in the current study. Bone marrow aspiration and biopsy was done in all ten cases as part of staging procedure. Results: Three patients showed involvement of bone marrow by Hodgkin’s lymphoma and both the patients had clinically poor outcome. Discussion and Conclusion: Bone marrow examination is important in stage II and III of Hodgkin”s lymphoma because positive result will upstage the disease. Also, bone marrow involvement indicates an aggressive disease and poor prognosis for the patient.

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Njomboro, Progress, and Shoumitro Deb. "Poor Dissociation of Patient-Evaluated Apathy and Depressive Symptoms." Current Gerontology and Geriatrics Research 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/846075.

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Apathy has traditionally been conceptualised as part of depression. The appropriateness of this conceptualisation has now been questioned, with the realization that apathy constitutes a distinct neuropsychiatric condition, with separate rehabilitation and patient-care implications to depression. Research on the relationship between apathy and depression has, however, produced mixed results. One reason for this inconsistency may lie behind who does the apathy evaluation. In this study we investigated whether the relationship between apathy and depression would differ when apathy was evaluated by the patients or an informant. A total of 49 brain damaged patients were assessed on self- and informant-rated Apathy Evaluation Scales. The relationship between the apathy scores and depressive symptoms was then investigated. Patient-rated, and not informant-rated apathy significantly correlated with depression. We discuss the implication of these results on the relationship between the two neuropsychiatric conditions and also in relation to the utility of patient self-evaluations in apathy.

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Damayanti, Triya, and Sri Pudyastuti. "Asthma in Pregnancy: Mechanism and Clinical Implication." Jurnal Respirologi Indonesia 40, no. 4 (October 23, 2020): 251–61. http://dx.doi.org/10.36497/jri.v40i4.125.

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Asthma in pregnancy can influence clinical status of an asthma patient. Study showed that one third of asthma patients were worsening, one third stable and one third improving. During pregnancy, lung function, ventilation pattern and gas diffusion are influenced by biochemistry (hormonal) and mechanic. Mechanism in pregnancy with asthma including hypoxia, inflammation, corticosteroids therapy, history of exacerbation, smoking mother and changes in placenta function. Hormonal status during pregnancy is different with non-pregnancy woman which hormonal level changes through the pregnancy time. Those changes can influence lung function in pregnancy. Treatment of asthma in pregnancy is giving optimal asthma therapy, therefore it can improve asthma control, also the quality of life of a mother and her fetus during pregnancy.

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Gecse, Krisztina B., and Christianne J. Buskens. "Implication of Medical Treatment for Surgical Strategies in IBD." Current Drug Targets 20, no. 13 (September 2, 2019): 1363–68. http://dx.doi.org/10.2174/1389450120666190515095520.

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Despite changing medical paradigm, still a significant proportion of patients with IBD require surgery. The patient's general condition, including nutritional status and the use of immunosuppressive medications is of great importance with regard to surgical complications, as well as the choice of optimal surgical strategy. The indication and the timing of surgery are key factors for the multidisciplinary management of IBD patients. The purpose of this review is to provide an overview on the impact of medical treatment on surgical strategies in IBD.

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Shin, Hyuk Soo, Dong Yeon Lee, and Doo Jae Lee. "Clinical Implication of Os subfibulare." Foot & Ankle Orthopaedics 2, no. 3 (September 1, 2017): 2473011417S0003. http://dx.doi.org/10.1177/2473011417s000374.

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Category: Ankle, Sports, Trauma Introduction/Purpose: Os subfibulare, defined as a separated ossicle of the distal fibular, has been linked to various clinical problems such as subfibulare pain and chronic lateral ankle instability. However, whether os subfibulare is congenital or traumatic remains unclear. The objectives of this study were: 1) to determine the incidence of os subfibulare development after ankle sprain in children and adolescents in a single primary care orthopedic clinic, and 2) to evaluate clinical implication of os subfibulare associated with ankle sprain in children and adolescents Methods: Among 896 pediatric patients (age ranging from 3 to 16 years) who visited a single primary care unit after sustaining ankle inversion injury, 627 patients who were followed up for over 2 weeks were included in this study. For each pediatric patient, physical examination and radiographic examination (anteroposterior, lateral, and mortise view of the bilateral ankle) were performed. The incidence of os subfibulare was evaluated based on initial radiographic examination. To analyze the incidence of new os subfibulare formation after ankle inversion injury, radiographs of 193 patients who were followed up for more than 6 months were evaluated according to the grade of injury. Results: At initial visit, 1% of examined ankles (13 from 1,254 ankles of 627 patients) showed well corticated ossicle not related to initial injuries. We cannot recognize the existence of accessory ossification center of the fibula in our study population. Overall incidence of os subfibulare at final follow up after ankle inversion injury was 23.9% (150/627). Os subfibulare at final follow up was correlated with initial injury grade (OR: 8.0, p = 0.001). In patients with initial avulsion fragment, 64.9% (61/94 cases) had residual ossicle at the final radiograph after being followed up for more than 6 months. As for the morphology of ossicle, 54 cases with wafer bone fragment at the time of initial injury showed oval or round shape ossicles at final radiograph. Conclusion: The incidence of os subfibulare at the initial radiograph was about 1%. The chance of ossicle formation after ankle inversion injury was substantially high in pediatric population. Based on the findings of our study, we carefully suggest that majority, if not all, of os subfibulare would be posttraumatic in pediatric period. Therefore, ankle inversion injury in children should be managed more actively to reduce the chance of posttraumatic os subfibulare formation.

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Yadak, Nour, and Dawn Moreau. "Implication of Auto-Anti-U Antibody in a Pediatric Patient." American Journal of Clinical Pathology 144, suppl 2 (October 1, 2015): A025. http://dx.doi.org/10.1093/ajcp/144.suppl2.025.

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Abdel Sammad, Ahmed Atwa, Maha El-Bassuoni, and Randa Mohamed Talaat. "An Implication of Epstein-Barr Virus in Hepatocellular Cancer Patient." Egyptian Journal of Medical Microbiology 22, no. 1 (January 2013): 109–16. http://dx.doi.org/10.12816/0004934.

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Papagno, Costanza, and Alan Baddeley. "Confabulation in A Dysexecutive Patient: Implication for Models of Retrieval." Cortex 33, no. 4 (January 1997): 743–52. http://dx.doi.org/10.1016/s0010-9452(08)70731-7.

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Layton, MR, S. Chadbunchachai, and SJ Kerr. "PSY55 PAIN MANAGEMENT IN THAILAND: IMPLICATION FOR BETTER PATIENT EDUCATION." Value in Health 11, no. 6 (November 2008): A646—A647. http://dx.doi.org/10.1016/s1098-3015(10)67105-7.

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Camara-Clayette, Valerie, Serge Koscielny, Thierry Lamy, Thierry Fest, Marc Bernard, and Vincent Ribrag. "Implication of BMP7 in Human Mantle Cell Lymphoma (MCL) Secondary Drug Resistance." Blood 108, no. 11 (November 16, 2006): 2589. http://dx.doi.org/10.1182/blood.v108.11.2589.2589.

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Abstract Despite a high response rate to 1st line chemotherapy, the probability of cure is very low in MCL. Secondary drug resistance invariably develops and the identification of mechanisms involved in this secondary drug resistance is a major challenge. We choose to track at a tumor level which genes are associated to the appearance of secondary drug resistance. The strategy was based on the use of paired samples from the same patient in order to control inter-patients variability. Five MCL patients had tumor samples collected from the same tissue before therapy and after failure. Two patients had refractory disease (non responders) and three achieved an objective response to therapy (responders). For each patient, pairs of samples from the same patient were co-hybridized on Agilent dual color DNA chips. Four DNA-chips were processed per patient (dye swap + replicate). The statistical analysis concentrated on variations in gene expression between the two samples from each patient. Each gene was analysed independently from the others. A multiple regression model (GLM procedure, SAS 8.2, Cary, NC, USA) was used to analyse the relation between the fold change in expression between the two samples of the same patient and several parameters including the response to treatment. Genes were selected on the basis of the absolute value of the coefficient associated to response to treatment. This absolute value was then expressed as a fold-change ratio (FCR), or ratio between the mean fold changes in responders and in non responders. Nineteen genes with a FCR greater than 2 and a P value < 10–6 were selected. FCR values larger than 5 were observed for CD69 (FCR=7.7) and BMP7 (FCR=7.0). Seventeen of the selected genes (89%) had a decreased expression at relapse in responders and an increased expression in non responders. The variation in expression according to response to therapy was in the reverse direction for the two remaining genes (BMP7 and TRAF5). The expression of TRAF5 decreased in non responders and remained unchanged in responders. In responders, the expression of BMP7, which was very low before treatment, was multiplied by about 8 after relapse, and did not vary in non responders. Because of this increase in expression, observed only in responders, BMP7 was considered as a major gene probably involved in secondary drug resistance. The possibility to interfere with its activity using miRNA was tested on JEKO cell line. JEKO cell line (EBV - MCL cell line) spontaneously express BMP7 and do not show growth inhibition when exposed in vitro to high concentration of BMP7. BMP7 RNA interference markedly increased necrosis (from 8.3% to 31.5%; P<0.05) of JEKO exposed to Bortezomide pointing BMP7 as a key gene involved in drug resistance. In conclusion, the patient oriented strategy is extremely powerful and permits relevant gene selection with a limited number of samples. Biologic validation with RNA interference confirms the relevance of this approach. Further investigations concerning the role of BMP7 and its possible use as a target for therapy are under investigation.

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Obande-Ogbuinya, Nkiru Edith, Lois Nnenna Omaka-Amari, Jude N. Nwafor, Chinenye B. Omeje, Maria-lauretta Chito Orji, Chihurumnanya Alo, Patricia C. Ngwakwe, et al. "Review of COVID-19 Re-Infection among Recovered Patients and Its Implication for Lung Health." Global Journal of Health Science 12, no. 12 (October 19, 2020): 64. http://dx.doi.org/10.5539/gjhs.v12n12p64.

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COVID-19 infection has continued to pose a very serious health threat to mankind globally despite all efforts geared toward curbing its spread. More worrisome recently is the report from different parts of the world on the re-infection of those treated and recovered with COVID -19 patients thus making containment of the virus even more difficult. Of more worrisome is the fact that the lung, a vital human organ is a major site being attacked by the virus even on re-infection cases. If quick action is not taken early enough, it may lead to the outright death of the patient. A lung infection, (Pneumonia) caused by COVID-19 has been discovered to be having a stunning effect on hospital systems and killing COVID-19 patients silently and it occurs even as the patient is asymptomatic. This paper examines the reasons for re-infection, Lacuna in the reviewed literature with regards to PCR test results, the effect of re-infection on the lungs, and implication for patients’ lung health. The papers summarized and concluded that it’s a fact that re-infection occurs among patients accompanied by mild or severe symptoms having far-reaching implications for the patient’s lung health. The paper recommends that the government at all levels should collaborate with WHO, CDC, and health policymakers to legally mandating, that every recovered patient should stay an additional 2weeks in the hospital for early detection of re-infection in order to avert any invasion and damage to the lungs thus ensuring lung health. Also, proper health education should be availed to the recovered patients to avoid any exposures or habits (different from the index disease) such as smoking that can pose dangers to the already fatigued lungs.

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Lu, Tianyu, and Jiayi Yang. "The implication and advantages of small-molecule drug." Theoretical and Natural Science 24, no. 1 (December 20, 2023): 76–80. http://dx.doi.org/10.54254/2753-8818/24/20231103.

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Small-molecule drugs are a widely used and theoretically mature therapeutic approach. Due to their small size and stable chemical structure, they can better penetrate the cell membrane and directly reach the intercellular target side, and their pharmacokinetics are more predictable. Many small-molecule drugs have contributed to medical advances and improved the lives of patients. At present, they have shown relatively high efficiency in the targeted treatment of a variety of diseases. In this review, we highlight their mechanisms and possibilities in the treatment of individual human diseases such as Alzheimers disease, cancer, and Covid-19 by comparing them with traditional macromolecular drugs, as well as the percentage of small molecule drugs used in current drugs, specific improvements in patient efficacy, or new insights into the mechanisms of action of small molecule drugs. For the prospects of small molecule drugs, new drugs will also emerge along with new challenges.

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Chase, Michael P., William M. Bauer, and Joseph C. Yarze. "Implication of detecting mucosal dysplasia in a patient with ulcerative colitis." American Journal of Gastroenterology 97, no. 6 (June 2002): 1561. http://dx.doi.org/10.1111/j.1572-0241.2002.05743.x.

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Verdaguer, M., N. Murguet, M. Adoun, L. Thiaudière, M. Mordelet, V. Levrat, and J. C. Meurice. "Éducation thérapeutique du patient asthmatique Rôle et implication du médecin généraliste." Revue des Maladies Respiratoires 23, no. 2 (April 2006): 200. http://dx.doi.org/10.1016/s0761-8425(06)71538-8.

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Maalej, M., E. Mkaouar-Rebai, M. Mnif, N. Mezghani, I. Ben Ayed, I. Chamkha, M. Abid, and F. Fakhfakh. "A mitochondrial implication in a Tunisian patient with Friedreich's ataxia-like." Pathologie Biologie 62, no. 1 (February 2014): 41–48. http://dx.doi.org/10.1016/j.patbio.2013.07.013.

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Kim, J., Y. Cha, S. Han, D. Oh, S. Lee, D. Kim, S. Im, T. Kim, D. S. Heo, and Y. Bang. "Prospective evaluation of oral mucositis in solid tumor patients undergoing chemotherapy and its clinical implication." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e20650-e20650. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e20650.

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e20650 Background: Oral mucositis (OM) induced by chemotherapy is a troublesome and debilitating adverse effect in solid tumor patients. OM might influence the complicated aspects such as the poor oral intake and malnutrition over just oral symptom. Therefore we prospectively evaluated the actual incidence of OM and its clinical significance in solid tumor patients. Methods: From October 16, 2007 to September 3, 2008, we consecutively enrolled 344 patients with solid tumor who initiated new chemotherapy. Each patient was prospectively evaluated for two cycles. The data were collected from physician-to-patient interview. And patients’ diary for OM symptom was used as patient-reported measurement. The visual analog scale (VAS) was used to quantify the degree of adverse effects (VAS: 0 point = no symptoms, 4 point = the worst symptom) and FACT-G was used for assessment of the quality of life (QOL). Results: Finally, 322 patients were analyzed. The median age was 51. Breast cancer was the most common (51%). And, stage IV was 137 (43%). OM was 28% per each cycle and 45% per patient during two cycles. Patient-reported OM symptom had peak in one week and was recovered in 9.14±6.77 days. Oral dryness was the most prevalent symptom out of symptoms related with OM such as oral pain, poor oral intake, dysphagia, oral bleeding, scalloping of tongue and ulceration (VAS score 1≤; 47%, 27%, 39%, 15%, 7%, 14%, 13%, respectively). In QOL measured by FACT-G, physical well-being and emotional well-being were significantly dropped in OM-occurred group than in no-OM group (19.09±6.48 vs 22.47±5.95, p<0.001; 16.74±4.10 vs 17.97±3.38, P<0.001, respectively). In addition, higher VAS score for other adverse effects was showed in OM-occurred group than in no-OM group (activity, nausea, vomiting, fever, myalgia and nervous system; p=0.0038, p<0.0001, p=0.0007, p=0.0062, p<0.0001, p<0.0001, respectively). Conclusions: Forty five percent of patients with solid tumor experience OM during 2 cycles of chemotherapy. In case of patients with OM, QOL is worse and the other adverse effects are more prevalent. OM could be an indicator of QOL and other adverse effects during chemotherapy. No significant financial relationships to disclose.

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Moncrief, Sara, Kellie L. Mathis, and Amy Lightner. "Long-standing Crohn’s disease and its implication on anal squamous cell cancer management." Journal of Clinical Oncology 35, no. 4_suppl (February 1, 2017): 576. http://dx.doi.org/10.1200/jco.2017.35.4_suppl.576.

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576 Background: Anal squamous cell carcinoma (ASCC) is rare, accounting for 1% of gastrointestinal malignancies, but the incidence is rising. Risk factors for the development of ASCC in patients with Crohn’s disease (CD) include immunotherapy, increased duration of disease, and chronic fistulizing perianal disease. We sought to understand management strategies for ASCC in the setting of CD. Methods: A retrospective review from 2001-2016 was conducted for ICD-9/10 codes pertaining to Crohn’s disease (CD) (555.9/ K50) and ASCC (154.3/C44.520). Adult patients with a diagnosis of CD at the time of ASCC diagnosis were included. Results: A total of 7 patients (5 female) were included with a median age of 50 years. The majority presented with perianal pain (4) and bleeding (3). The mean duration of CD was 20 years, and all patients had perianal disease for > 10 years. Five patients had perianal fistulizing disease at the time of ASCC presentation. Clinical stage at diagnosis of ASCC was stage 0 (n = 1), I (n = 1), II (n = 1), III (n = 2), IV (n = 1), and unknown (n = 1). All patients were treated with Nigro protocol which included radiation (50-55Gy), 5-fluorouracil, and mitomycin; 1 patient received cisplatin due to concurrent Non-Hodgkin’s Lymphoma. Three patients required fecal diversion during radiation due to significant perianal disease. Two patients experienced complications related to radiation including anal and vaginal stenosis and an anovaginal fistula. One additional patient required an APR with rectus abdominis myocutaneous flap for uncontrolled CD after treatment. During follow-up, 3 of the 7 patients undergoing definitive chemoradiation developed residual or recurrent disease and required salvage APR. All patients were alive at last follow-up, 2 with metastatic disease. 5-year disease free survival was 56%. Conclusions: Patients with ASCC in the setting of CD may be managed with the standard Nigro protocol, but complications from radiation are common in this setting. Three of seven patients required salvage surgery for residual or recurrent disease, and an additional patient required APR for palliation of CD symptoms. Given the aggressive nature of ASCC in this population, surveillance guidelines are necessary.

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Nielsen, Marie Konge, and Helle Johannessen. "Patient empowerment and involvement in telemedicine." Journal of Nursing Education and Practice 9, no. 8 (April 28, 2019): 54. http://dx.doi.org/10.5430/jnep.v9n8p54.

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Objective: Telemedicine is a rapidly expanding area, and this article discusses the implications of patient empowerment and user involvement in relation to frail patients. Our aim is to critique the mechanical way telemedicine is being implemented in the health sector.Methods: We present the basic ideas of empowerment and user involvement behind telemedicine, exemplifying them with a case of user resistance to telemedicine. Four logics of empowerment are employed to identify the underlying rationale in specific cases of telemedicine. The case comes from a large evaluation of new welfare technology products. The data consist mainly of written documents and an interview.Results: Telemedicine is often considered a way to increase empowerment and user involvement in healthcare. The majority of the geriatric patients in the described case refused to engage in telemedicine, preferring instead to be hospitalized. The case appeared to be driven primarily by a professional logic of empowerment. User involvement and empowerment are discussed in terms of their demands and implication for users, such as 1) intrusion on the private sphere, i.e., the home and 2) the question of the responsibility for treatment and 3) the expectation, that the capabilities and resources of patients and relatives may increase.Conclusions: Although telemedicine is acknowledged as relevant, a mechanical approach too often hampers empowerment for the patient. Some patient groups may not feel safe using telemedicine, in which case user involvement and empowerment are not possible.

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Suttagul, Kanokwan, and Vinai Sirichitra. "COVID-19 Pandemic in ASEAN Region and Implication in Dentistry." Open Access Macedonian Journal of Medical Sciences 8, T1 (October 26, 2020): 465–70. http://dx.doi.org/10.3889/oamjms.2020.5453.

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The coronavirus disease (COVID-19) has spread globally and has influenced every aspect of life worldwide. In the ASEAN region, at present, many nations are still locked the academic organizations, shopping malls, events, and activities, and banks and airports are shut down to prevent the spread of the COVID-19 infection. COVID-19 has affected dental practice, and, in many countries, dentists are affected by COVID-19, leading to deaths. The dental treatments should be done with high standards of care and infection control by following proper recommendations. Personal protective equipment, patient screening, hand hygiene practices, mouth rinsing, disposable instruments, and use of rubber dam, reducing ultrasonic instruments use, treating suspected or confirmed COVID-19 patients in separate rooms, and disinfection of the inanimate surfaces helps in protecting clinicians and patients.

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Turner, Ralph R. "Role of Quality of Life in Hypertension Therapy: Implication for Patient Compliance." Cardiology 80, no. 1 (1992): 11–22. http://dx.doi.org/10.1159/000175043.

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Hayes, S. J. "Terminal digit preference occurs in pathology reporting irrespective of patient management implication." Journal of Clinical Pathology 61, no. 9 (August 28, 2008): 1071–72. http://dx.doi.org/10.1136/jcp.2008.059543.

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Tocci, Gregory C. "The implication of door undercut in patient room to corridor speech privacy." Journal of the Acoustical Society of America 135, no. 4 (April 2014): 2402. http://dx.doi.org/10.1121/1.4877951.

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Martini, M., F. Parazzini, and V. Agnoletto. "Characteristics of doctor-patient relationship and implication on adherence to antiretroviral treatments." HIV Medicine 2, no. 1 (January 2001): 62–63. http://dx.doi.org/10.1046/j.1468-1293.2001.00054.x.

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Lee, Eun‐Jae, Young‐Min Lim, Seungmi Kim, Lynkyung Choi, Hyunjin Kim, Keonwoo Kim, Hye Weon Kim, Ji Sung Lee, and Kwang‐Kuk Kim. "Clinical implication of serum biomarkers and patient age in inflammatory demyelinating diseases." Annals of Clinical and Translational Neurology 7, no. 6 (June 2020): 992–1001. http://dx.doi.org/10.1002/acn3.51070.

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Zagari, Maria Carmela, Paola Chiarello, Stefano Iuliano, Lucia D’Antona, Valentina Rocca, Emma Colao, Nicola Perrotti, Francesca Greco, Rodolfo Iuliano, and Antonio Aversa. "The Variant p.Ala84Pro Is Causative of X-Linked Hypophosphatemic Rickets: Possible Relationship with Burosumab Swinging Response in Adults." Genes 14, no. 1 (December 27, 2022): 80. http://dx.doi.org/10.3390/genes14010080.

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Loss of function mutations in the PHEX gene could determine X-linked dominant hypophosphatemia. This is the most common form of genetic rickets. It is characterized by renal phosphate wasting determining an increase in fibroblast growth factor 23 (FGF-23), growth retard, bone deformities and musculoskeletal manifestations. In recent decades, analysis of the PHEX gene has revealed numerous different mutations. However, no clear genotype-phenotype correlations have been reported in patients with hypophosphatemic rickets (XLH). We report two cases of a 28-year-old-male (patient 1) and a 19-year-old male (patient 2) affected by XLH initially treated with phosphate and 1,25-dihydroxyvitamin–D admitted to the Endocrinology unit because of the persistence of muscle weakness, bone pain and fatigue. After phosphate withdrawal, both patients started therapy with burosumab and symptoms ameliorated in three months. However, patient 1’s biochemical parameters did not improve as expected so we decided to investigate his genetic asset. We herein describe a possible clinical implication for the missense “de novo” mutation, c.250G>C (p.Ala84Pro) in the PHEX gene, reported in the PHEX database and classified as a variant of uncertain significance (VUS). The clinical implication of this mutation on disease burden and quality of life in adults is still under investigation.

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KONG, T., J. GILLES DE LA LONDE, P. ELOY, M. CLAUDON, and L. BUNGE. "Implication pédagogique de patients experts pour améliorer l’approche centrée sur le patient des internes en médecine générale." EXERCER 31, no. 165 (September 1, 2020): 333–34. http://dx.doi.org/10.56746/exercer.2020.165.333.

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Contexte : Un auto-questionnaire de mesure de l’approche centrée patient (ACP), intitulé Patient Perception of Patient Centeredness (PPPC), a été développé par Stewart et al. en anglais et a été traduit en français. Trois des quatre composantes de l’ACP, décrites par Stewart (2014) y sont représentées : la composante 1 « explorer l’expé-rience de la maladie », la composante 2 « comprendre la personne dans sa globalité biopsychosociale » et la compo-sante 3 « trouver un point d’entente commun ». Dorénavant, les patients sont reconnus pour leurs savoirs expérien-tiels et certains deviennent des patients experts (PE), qui interviennent dans l’enseignement auprès de soignants et/ou dans les milieux de soins auprès de patients. Objectif : L’objectif était d’évaluer si l’intégration de PE dans un enseignement à la relation médecin malade (RMM) améliorait l’ACP des internes en médecine générale (IMG). Méthodes : Dans cette étude prospective, interventionnelle qui s’est déroulée en octobre 2017, les internes devant assister à l’enseignement RMM ont été répartis aléatoirement entre les groupes intervention (avec PE) et contrôle (sans PE). Après l’enseignement, les internes participaient à une consultation simulée en jouant le médecin. Un pa-tient standardisé jouait le patient et remplissait la version française du questionnaire PPPC. Résultats : 58 internes ont participé à l’enseignement RMM et 45 à la consultation simulée. Il n’y avait pas de diffé-rence statistiquement significative entre les deux groupes pour le score global du questionnaire PPPC (p = 0,49), ni pour celui des composantes 1 (p = 0,25) et 3 (p = 0,59). Il n’y avait pas de calcul de score pour la composante 2. Conclusion : Notre étude n’a pas permis d’évaluer l’apport des PE sur l’amélioration de l’ACP. L’amélioration d’une compétence semble dépendre de plusieurs facteurs et non d’une intervention unique. Les PE peuvent apporter d’autres points pertinents autres que l’amélioration de l’ACP lors des enseignements.

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Kalu, Queeneth, Nathaniel Usoro, Otu Etta, Roseline Eshiemomoh, and Joseph Enabulele. "Prevalence of pre-operative anemia and its implication for patient blood management in a Nigerian Hospital." Calabar Journal of Health Sciences 6 (November 26, 2022): 59–64. http://dx.doi.org/10.25259/cjhs_1_2022.

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Objectives: Pre-operative anemia is common in Sub-Saharan Africa including Nigeria. Anemia is a known risk factor for blood transfusion. In our hospital, like many others, patients are usually admitted a day before elective surgeries and the default treatment for anemia by most surgeons and anesthetists is allogenic blood transfusion. Anemia and blood transfusion are independently and synergistically associated with complications and undesirable outcomes. Patient blood management (PBM) is gaining popularity and has been advocated by the World Health Organization (WHO) for member countries to adopt as a means of improving patient outcomes. There is currently no research from the University of Calabar Teaching Hospital highlighting the prevalence of pre-operative anemia. This research was aimed at filling this gap and also presenting a baseline for comparison as the hospital strives to implement the three pillars of PBM strategies: Manage anemia, minimize blood loss and harness tolerance to anemia to improve patient outcomes. Material and Methods: All surgical patients who consented to the study were recruited prospectively. Patients who had no pre-operative hemoglobin (Hgb) or packed cell volume (PCV) recorded were excluded from the study. Demographic data, type of surgery, and pre-operative PCV levels were documented. Anemia was defined using the WHO standard as PCV <39% (Hgb 13.0 g/dL) in men and <36% (Hgb 12.0 g/dL) in women. Data were obtained about transfusion at the end of surgery. Surgeries were categorized into general, orthopedic, obstetric, gynecological, urologic, pediatric, ear, nose, throat/maxillofacial, burns and plastic unit (BPU), neurological, and thoracic. The information was entered into SPSS version 20. Data were cleaned and analyzed. The statistical significance was placed at P < 0.05. Results are presented as tables, chats, and histograms. Results: A total of 237 patients were recruited with a mean age of 37.30 ± 19.05. More of them were females (54.0%) and a higher proportion of them (64.6%) had elective surgery. The categories of surgeries were predominantly general surgical (24.9%) and gynecological (21.9%) followed by orthopedic (17.7%), ENT/maxillofacial (9.3%), urologic (8.0%), and obstetric (7.2%) cases. The rest were neurosurgical (3.4%) and pediatric surgical (2.1%) cases. The overall prevalence of anemia was found to be 54.9%. The mean pre-operative PCV was 34.90 ± 7.37%. The highest proportion of pre-operative anemia was found among the pediatric surgical cases (80.0%) followed by the urologic (68.4%) and neurosurgical cases (62.5%). The prevalence of pre-operative anemia among the different surgical patients was gynecological (46.2%), general surgical (45.8%), obstetric (41.2%), ENT/maxillofacial (40.9%), and orthopedic (38.1%) cases. The lowest proportion of pre-operative anemic patients was found among the thoracic (25.0%) and Burns and Plastics (11.1%) cases. Most of the patients (86.5%) were not transfused intraoperatively. Whereas 20% of the anemic patients were transfused; only 5.6% of the non-anemic ones needed a blood transfusion. Conclusion: Pre-operative anemia remains prevalent in our environment and anemia is a risk factor for a blood transfusion which carries both risk and cost implications. PBM has as its first pillar the management of anemia. This pre-emptive approach to allogeneic blood transfusion avoidance is aimed at improving patient outcomes. Prevention and treatment of pre-operative anemia will be beneficial not just to the patients but to all healthcare stakeholders.

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Sanaee, Layli. "Medical education reform: a catalyst for strengthening the health system." Canadian Medical Education Journal 10, no. 4 (November 28, 2019): e57-e61. http://dx.doi.org/10.36834/cmej.61619.

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Key points: Medical education reform of Canadian specialist doctors presents a unique opportunity for designing parallel health systems interventions. Applying a Health System Framework reveals wider implications of Competence by Design (CBD) and provides impetus for health system strengthening. CBD implications may include staffing shortages in academic hospitals, annual variation in medical education financing needs, new roles for clinician teachers, and greater demand for human health resource surveillance and patient outcome monitoring and analysis. Each implication provides an opportunity to strengthen Governance and Leadership processes, namely by increasing coordination, harmonization, and system responsiveness.

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Sooriyagoda, S. K. G. P. H. K., R. M. M. K. Amarasinghe, H. S. R. Kumara, S. R. Jayawickreme, and A. H. M. T. B. Abeysinghe. "Factors Contributing to Delayed Presentation In ST-Elevation Myocardial Infarction and Implication for In-Patient Outcomes." Sri Lanka Journal of Medicine 33, no. 1 (April 5, 2024): 32–38. http://dx.doi.org/10.4038/sljm.v33i1.428.

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Introduction: ST-elevation myocardial infarction (STEMI) is a significant cause of mortality and morbidity among patients with ischemic heart disease. Early intervention, such as primary percutaneous coronary intervention (PPCI) or thrombolysis has been shown to improve patient outcomes. However, delayed presentation in STEMI results in larger infarct size and increased complications.Objectives: This retrospective descriptive study aimed to identify factors contributing to delayed presentation in STEMI and in-patient outcomes.Methodology: A retrospective descriptive study was conducted. All the STEMI patients who underwent primary percutaneous coronary intervention at National Hospital Kandy from February 2019 to December 2019 were studied.Results: A total of 243 STEMI patients who underwent PPCI at the National Hospital Kandy from February 2019 to December 2019 were studied. Among the study population, 31.27% were delayed presenters and 68.72% were non–delayed presenters. Atypical chest pain was identified as the main reason for a delayed presentation. Female gender was not associated with delayed presentation, contrary to the findings in other studies. Diabetes mellitus and the location of the culprit lesion did not significantly contribute to delayed presentation in this study group. Complications during hospital stay and average duration of hospital stay were not significantly different between delayed and non-delayed presenters. However, delayed presenters exhibited lower left ventricular ejection fraction on discharge, which is a critical predictor of short and long-term outcomes.Conclusions: Community awareness programs are essential to minimize pre-hospital delays in STEMI presentation. Early recognition of atypical symptoms, irrespective of gender, and timely intervention are vital for improving outcomes in STEMI patients. Further research is warranted to explore the impact of other risk factors and co-morbidities on the duration of presentation in STEMI patients.

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Charest, Mathieu, and Shadia Armanious. "Prognostic Implication of the Lymphangitic Carcinomatosis Pattern on Perfusion Lung Scan." Canadian Association of Radiologists Journal 63, no. 4 (November 2012): 294–303. http://dx.doi.org/10.1016/j.carj.2011.04.004.

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Purpose Findings not associated with thromboembolic disease on routine perfusion lung scan may sometimes have particular clinical significance. We wanted to assess the clinical importance and overall survival after the recognition of a lymphangitic carcinomatosis pattern on perfusion lung scan. Case report We report a case of lymphangitic carcinomatosis pattern on perfusion lung scan performed in a previously healthy patient who had rapid progressive course and died the next day. Method A Medline search of case reports that describes either lymphangitic carcinomatosis or tumour microemboli on perfusion lung scan. Results There were a total of 32 patients identified in 21 articles from various countries, including our case. The studied perfusion pattern was reported more often in female patients (81%) was associated with a progressive history of dyspnea (69%) and normal or mild findings on chest radiograph (58%). Of the 29 patients with available outcome data, 79% (23/29) had a progressive course after the lung scan interpretation. In 18 of these 23 cases, the actual interval of survival was given: 67% of these patients (12/18) died within the first month. Discussion A lymphangitic carcinomatosis perfusion pattern on scintigraphic imaging is associated with a poor prognosis. Nuclear medicine physicians should be aware of this association and that raising the suspicion for a metastatic process may make a difference in the treatment plan of these patients.

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Lee, Sul-Hee, Youin Bae, and Young-Lip Park. "Clinical Implication of Serum Adiponectin Levels in Adult Patients with Atopic Dermatitis." Journal of Clinical Medicine 11, no. 21 (October 24, 2022): 6255. http://dx.doi.org/10.3390/jcm11216255.

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Atopic dermatitis (AD) is characterized by chronic, relapsing, pruritic inflammatory skin disease. Adiponectin has been reported to have anti-inflammatory effects not only on metabolic disorders but also on various inflammatory disorders. The study aimed to validate adiponectin as a potential biomarker for AD disease severity and treatment response. Seventy-five patients with AD and 28 healthy volunteers were enrolled in the study. Patient information, including Eczema Area and Severity Index (EASI) scores and pruritus numeric rating scales (NRSs), were collected. An enzyme linked immunosorbent assay (ELISA) was conducted to measure levels of serum adiponectin. Additionally, sera of patients treated with dupilumab were collected and measured at 16 and 52 weeks from baseline. Serum adiponectin levels were significantly lower in moderate and severe AD patients than in the control and mild AD patients. Serum adiponectin level was negatively correlated with the EASI score and pruritus NRS. However, no significant changes were observed according to biologic treatment for AD. Low serum adiponectin levels are associated with moderate to severe AD, suggesting a potential role for adiponectin as a biomarker for severity assessment of AD.

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Grebenyuk, O. V., N. S. Novikova, and V. M. Alifirova. "The characteristic vegetative control heart activity by vertigo central genesis." Bulletin of Siberian Medicine 8, no. 3(2) (June 28, 2009): 86–88. http://dx.doi.org/10.20538/1682-0363-2009-3(2)-86-88.

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We investigate vegetative regulation heart activity by 15 patients with temporal lobe epilepsy and 15 with syndrome vegetative dysfunction. We detect increase sympatic tonus at rest and low arousal sympatic part by realization orthostatic test by patient with vertigo central genesis as against with healthy. It is our belief that detect disturbance related to implication in pathological process suprasegmental part statokinetic analyzator.

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Rohit, Rohit, Manvi Sharma, Mayank Nangru, and Ankit Gulia. "Implication of inflammatory markers in post COVID syndrome." International journal of health sciences 7, S1 (September 15, 2023): 2644–51. http://dx.doi.org/10.53730/ijhs.v7ns1.14558.

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Post-COVID syndrome was described in the context of a survey of prolonged COVID-19 symptoms for the first time in 2020, run by the Patient-Led Research Collaborative, citizen’s scientist group. Symptoms persisting for more than three weeks after the diagnosis of COVID-19 fall into the category of post-COVID syndrome. The most common post-COVID symptoms include fatigue, dyspnea, olfactory and gustatory dysfunction, chest pain, myalgia, and sleep and mental disorders. The pathogenesis of post-COVID syndrome is multi-factorial. Underlying chronic, low grade inflammation has been theorized for pathogenesis. Available data shows conflicting results regarding the implication of inflammatory markers in full clinical spectrum and its long-term outcome.

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Srivastava, Amit, Rachit Sharma, Jay Manchanda, Charu Sadhwani, and Afrah Sharif. "EFFECT AND IMPLICATION OF BRONCHOSCOPIC BALLOON DILATATION IN A CASE OF TOTAL LUNG COLLAPSE." Era's Journal of Medical Research 10, no. 01 (June 2023): 143–45. http://dx.doi.org/10.24041/ejmr2023.24.

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It is relatively uncommon for a young patient to have a severe airway blockage. Clinical suspicion of severe endobronchial anatomic alterations is uncommon. In certain situations, bronchoscopy results or radiographic findings are helpful in further assessment. Sarcoidosis, TB, and vasculitides cannot be diagnosed in our case because there is no clinical, radiological, or pathological evidence of these conditions. It is important to identify between benign and malignant tracheobronchial stenosis aetiologies, as well as to take into account the degree of aggression depending on the underlying condition and likelihood of cure. Additionally, it's crucial to take into account whether the obstruction is dynamic (tracheobronchomalacia) or fixed, particularly in the case of benign disease.

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Saberi, Kianoush, Mehrdad Salehi, Mehrzad Rahmanian, AliReza Bakhshandeh, and Mohammad Mahlabani. "Anesthetic implication of tricuspid valve replacement in a patient with acute intermittent porphyria." Annals of Cardiac Anaesthesia 19, no. 2 (2016): 367. http://dx.doi.org/10.4103/0971-9784.179623.

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Pape, Elise, Emilie Roman, Julien Scala-Bertola, Carine Thivilier, Lucie Javot, Franck Saint-Marcoux, Jean Yves Jouzeau, and Nicolas Gambier. "Death of an Alcohol-Dependent Patient following Intentional Drug Intoxication: Implication of Baclofen?" European Addiction Research 20, no. 6 (2014): 300–304. http://dx.doi.org/10.1159/000362409.

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Verla, Terence, Owoicho Adogwa, Parastou Fatemi, Joel R. Martin, Oren N. Gottfried, Joseph Cheng, and Robert E. Isaacs. "Clinical implication of complications on patient perceived health status following spinal fusion surgery." Journal of Clinical Neuroscience 22, no. 2 (February 2015): 342–45. http://dx.doi.org/10.1016/j.jocn.2014.05.053.

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Zafar, Arif, Parag Sayal, Anthony Jesurasa, and Chittoor Rajaraman. "The implication of delays in patient discharge: The experience of a neurosurgical centre." International Journal of Surgery 11, no. 8 (October 2013): 658. http://dx.doi.org/10.1016/j.ijsu.2013.06.382.

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Polvani, Simone, Mirko Tarocchi, Sara Tempesti, Tommaso Mello, Elisabetta Ceni, Francesca Buccoliero, Massimo D'Amico, et al. "COUP-TFII in pancreatic adenocarcinoma: Clinical implication for patient survival and tumor progression." International Journal of Cancer 134, no. 7 (October 15, 2013): 1648–58. http://dx.doi.org/10.1002/ijc.28502.

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Kim, Namhee, Kye-Hyung Kim, Su Jin Lee, Sang-Hyuk Park, In-Suk Kim, Eun Yup Lee, and Jongyoun Yi. "Bone marrow findings in severe fever with thrombocytopenia syndrome: prominent haemophagocytosis and its implication in haemophagocytic lymphohistiocytosis." Journal of Clinical Pathology 69, no. 6 (November 16, 2015): 537–41. http://dx.doi.org/10.1136/jclinpath-2015-203417.

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AimsSevere fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease caused by the SFTS virus; primary manifestations are fever, thrombocytopenia, leukopenia and gastrointestinal symptoms. Before an aetiological diagnosis is made, SFTS patients can undergo bone marrow examination due to cytopenias. Although several studies have reported on bone marrow examination in SFTS patients, most do not provide adequate details. Bone marrow findings in SFTS patients were investigated in this study.MethodsAn observational study was conducted in SFTS patients who were hospitalised between 2013 and 2014 in two university hospitals in South Korea. Patients were included in the study if SFTS was confirmed by real-time PCR for the SFTS virus and a bone marrow examination was conducted. The morphologic findings of the bone marrow samples were reviewed.ResultsThree cases met the study inclusion criteria. One patient died of multiple organ failure. Haemophagocytosis was evident in the bone marrow samples of all three patients. Histiocytic hyperplasia and haemophagocytosis were more pronounced in the fatal case. One patient was diagnosed as having haemophagocytic lymphohistiocytosis.ConclusionsHaemophagocytosis in the bone marrow of SFTS patients may be common. In SFTS endemic areas, SFTS should be one of the differential diagnoses of fever of unknown origin with haemophagocytosis in the bone marrow.

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Lee, Jae-Myeong, Bong-Wan Kim, Wook Hwan Kim, Hee-Jung Wang, and Myung Wook Kim. "Clinical Implication of Bile Spillage in Patients Undergoing Laparoscopic Cholecystectomy for Gallbladder Cancer." American Surgeon 77, no. 6 (June 2011): 697–701. http://dx.doi.org/10.1177/000313481107700623.

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We determined the influence of bile spillage on recurrence and survival during laparoscopic cholecystectomy (LC) for gallbladder (GB) cancer. Among the 136 patients with GB cancer treated at Ajou University Hospital between 1994 and 2007, 28 underwent LC alone. We compared patients without bile spillage (bile spillage [-] group, n = 16) with patients who had bile spillage (bile spillage [+] group, n = 12). There was no statistical difference in stage between the groups. In the bile spillage (-) group, all patients underwent curative resection and there were two patients with locoregional recurrences and three patients with systemic recurrences. In the bile spillage (+) group, five patients underwent R1 resection and one patient underwent R2 resection and all eight recurrent patients had systemic recurrences. The disease-free survival and overall survival were shorter in the bile spillage (+) group (disease-free survival, 71.4 vs 20.9 months; P = 0.028; overall survival, 72.6 vs 25.8 months; P = 0.014). Bile spillage is likely to be an association with an incomplete resection and systemic recurrences. When GB cancer is suspected during LC, conversion to open surgery for preventing bile spillage and achieving curative resection should be considered.

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Lu, J., S. Eppler, J. Ling, M. Prados, B. Klencke, and B. Lum. "Clinical pharmacokinetics of erlotinib (E) in glioblastoma multiforme (GBM) patients and its implication for dosing." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 2010. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.2010.

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2010 Background: E is an orally active, highly potent and selective inhibitor of the epidermal growth factor receptor (EGFR). Preliminary results from both Phase I and Phase II trials of E in GBM patients have been reported (ASCO 2003, Abs#394 and ASCO 2004, Abs#1555). The purpose of this analysis is to characterize E PK in this patient population when administered with or without CYP3A4 enzyme inducing anti-epileptic drugs (EIAEDs) and to identify a dose to provide equivalent exposure during concomitant therapy in GBM patients. Methods: Intensive PK data were collected in the Phase I study and plasma trough concentration data were collected in the Phase II study at steady-state. A total of 775 E concentrations from 107 patients were available for the analysis. A population PK approach (NONMEM) was used to characterize the clinical PK in this patient population and the effect of EIAEDs on the PK of E. Results: Co-administration of EIAEDs was shown to increase the E clearance (CL/F) by 230% in GBM patients. This effect is similar to that seen in a previous drug-drug interaction study with a CYP3A4 enzyme inducer (rifampicin) in healthy volunteers. For patients with no EIAEDs, population estimates and the %CV of inter-individual variance for CL/F and Vc/F of erlotinib were 5.63 L/hr (44%) and 388 L (40%), respectively. Conclusions: Based on the modeling results, for GBM patients with EIAEDs, an estimate of erlotinib dose of 500 mg/d is needed to achieve an equivalent exposure as patients who receive the dose of 150 mg/d with no EIAEDs. The new population PK model provides an operational tool to predict E exposure during treatment, and simulate alternative dosing regimens for GBM patients. [Table: see text]

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Roychowdhury, Ashimesh. "Mental capacity assessments in secure care: an unnecessary complication?" Psychiatric Bulletin 33, no. 12 (December 2009): 461–64. http://dx.doi.org/10.1192/pb.bp.108.020115.

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SummaryThis is a review of the key criteria and implications of the Mental Capacity Act 2005 for patients in forensic care detained under the Mental Health Act 1983. Both Acts were amended by the Mental Health Act 2007 and its subsequent Code of Practice; the impact of these changes will be explored here. Through review of the Code of Practice and hypothetical clinical scenarios, I argue that capacity judgements in mental disorder are inherently complex, unreliable and inextricably linked to risk assessment, and that an overemphasis on capacity when making decisions about patient management in secure care can paradoxically obscure the more central issue of risk and proportionality. the key clinical implication is a call for secure services to be balanced in how they adopt best practice principles from the new Mental Capacity Act so that the spirit of the Act, such as valuing patient autonomy, is preserved and that the debate about what practices in secure care are truly proportionate and justified remains at the forefront of clinical thinking.

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Journal articles on the topic 'Implication du patient'

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