Letteratura scientifica selezionata sul tema "Iatrogenic risk"
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Articoli di riviste sul tema "Iatrogenic risk":
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Duncan, Darlene R., Timothy I. Morgenthaler, Jay H. Ryu e Craig E. Daniels. "Reducing Iatrogenic Risk in Thoracentesis". Chest 135, n. 5 (maggio 2009): 1315–20. http://dx.doi.org/10.1378/chest.08-1227.
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Pravitasari, Pravitasari, Eugenius Phyowai Ganap e Addin Trirahmanto. "Analisis Faktor Risiko Cedera Buli Iatrogenik pada Operasi Obstetri". Jurnal Kesehatan Reproduksi 9, n. 1 (15 agosto 2022): 55. http://dx.doi.org/10.22146/jkr.74830.
Abstract (sommario):
Background: Bladder is one of urinary tract that is anatomically close to gynecological organs. The risk of iatrogenic bladder injuries is an undesirable event. It can increase in obstetric and gynecological procedures. We can identified the risk factors for iatrogenic bladder injuries can be identified at the beginning of operations. One of which is related to distorted pelvic anatomy, including adhesions, history of surgery, endometriosis and obesity. The type of surgery also plays a role in increasing risk of iatrogenic bladder injuries. This study aims to determine the risk factors that can increase iatrogenic bladder injuries in obstetric and gynecological surgery at Dr. RSUP. Sardjito in 2015-2020.Objective: To determine the risk factors that increase iatrogenic bladder injury in obstetric and gynecological surgery at dr. Sardjito in 2015-2020Method: Case control study was conducted at Dr. RSUP. Sardjito, Yogyakarta from January 2021 to March 2022. There were 120 patient subjects who underwent obstetric and gynecological procedures at Dr. Sardjito Hospital from 2015 to 2020 who entered the inclusion criteria. The relationship between risk factors and the incidence of iatrogenic bladder injuries was analyzed using the Chi Square test. Multivariate analysis to determine the most important risk factors were analyzed using Logistic Regression test. Data analysis with SPPS version 22.0Results and Discussion: In this study, there was an association between adhesions and the incidence of iatrogenic bladder injuries (OR = 28,895 (95% CI 9111 – 91,641); p < 0.001). However, there was no association between endometriosis, type of surgery, previous surgery, body mass index, age, parity, amount of bleeding, timing of surgery and malignancy with the incidence of iatrogenic bladder injuries (p > 0.05).Conclusion : Adhesions had 29 times risk for increasing iatrogenic bladder injuries in this study.Keywords: Adhesions, Distorted Pelvic Anatomy, Risk Factors, Iatrogenic Bladder Injuries, Obstetrics, Gynaecology
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Hodge, William G., Jean-François Boivin, Stanley H. Shapiro, Richard G. Lalonde, Kirtida C. Shah, Bradley D. Murphy, Michel A. Dionne e Aashish Goela. "Iatrogenic risk factors for cytomegalovirus retinitis". Canadian Journal of Ophthalmology 40, n. 6 (dicembre 2005): 701–10. http://dx.doi.org/10.1016/s0008-4182(05)80086-9.
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Arroyo-Novoa, Carmen Mabel, Milagros I. Figueroa-Ramos e Kathleen A. Puntillo. "Opioid and Benzodiazepine Iatrogenic Withdrawal Syndrome in Patients in the Intensive Care Unit". AACN Advanced Critical Care 30, n. 4 (15 dicembre 2019): 353–64. http://dx.doi.org/10.4037/aacnacc2019267.
Abstract (sommario):
Iatrogenic withdrawal syndrome is an increasingly recognized issue among adult patients in the intensive care unit. The prolonged use of opioids and benzodiazepines during the intensive care unit stay and preexisting disorders associated with their use put patients at risk of developing iatrogenic withdrawal syndrome. Although research to date is scant regarding iatrogenic withdrawal syndrome in adult patients in the intensive care unit, it is important to recognize and adequately manage iatrogenic withdrawal syndrome in order to prevent possible negative outcomes during and after a patient’s intensive care unit stay. This article discusses in depth 8 studies of iatrogenic withdrawal syndrome among adult patients in the intensive care unit. It also addresses important aspects of opioid and benzodiazepine iatrogenic withdrawal syndrome, including prevalence, risk factors, and assessment and considers its prevention and management.
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Melnichenko, Galina A., e Elizaveta O. Mamedova. "Iatrogenic lesions of the skeleton". Obesity and metabolism 13, n. 2 (13 luglio 2016): 41–47. http://dx.doi.org/10.14341/omet2016241-47.
Abstract (sommario):
Osteoporotic fractures are an important public health problem due to their negative impact on the quality of life and life expectancy, as well as high cost of treatment and rehabilitation. Along with the major risk factors for osteoporotic fractures, such as low bone mineral density (BMD), age, low body weight, frequent falls and previous fractures, an important secondary risk factor, especially among susceptible individuals, is taking certain medications. The difficulty in assessing fracture risk when taking various drugs, as well as the development of appropriate methods of prevention and treatment, is often due to the absence of large randomized trials with a sufficient level of evidence, as well as the heterogeneity of the main risk factors for fractures in studied groups of patients. We focus on the main groups of drugs for which there is evidence of a negative impact on bone metabolism, BMD and fracture risk. In addition to drugs, bone metabolism is also influenced by bariatric surgery, transplantation of solid organs, gonadectomy for various diseases.
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Pomerantz, Rebecca G., David A. Lee e Daniel M. Siegel. "Risk assessment in surgical patients: balancing iatrogenic risks and benefits". Clinics in Dermatology 29, n. 6 (novembre 2011): 669–77. http://dx.doi.org/10.1016/j.clindermatol.2011.08.012.
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Wong, P. K. K. "Predicting infection risk in iatrogenic immune deficiency". Pathology 54 (marzo 2022): S24. http://dx.doi.org/10.1016/j.pathol.2021.12.081.
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Aldous, M. B. "Iatrogenic Risk of School-Based Suicide Screening". AAP Grand Rounds 14, n. 1 (1 luglio 2005): 6. http://dx.doi.org/10.1542/gr.14-1-6.
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Mendyka, BE, JM Clochesy e ML Workman. "Latex hypersensitivity: an iatrogenic and occupational risk". American Journal of Critical Care 3, n. 3 (1 maggio 1994): 198–201. http://dx.doi.org/10.4037/ajcc1994.3.3.198.
Abstract (sommario):
BACKGROUND Immediate hypersensitivity reactions to natural rubber and latex products were first reported in 1979 by Nutter, who identified contact urticaria to latex gloves. Since that time, numerous cases of immediate and delayed reactions to latex have been reported. Because latex products are ubiquitous, especially in the critical care environment, there is increasing risk of hypersensitivity among patients and healthcare workers. METHOD Literature review. OBJECTIVES To review the types of allergic reaction to latex and to inform healthcare providers of the risks to patients and themselves of acquiring latex hypersensitivity. CONCLUSION Immediate hypersensitivity reactions to natural rubber and latex products pose a significant threat to patients, healthcare workers, and the general population. Medical history alone is inadequate to identify all persons at risk. Numerous proteins doubtless exist in latex that may be the link to allergenicity. Further research is needed to address demographic, behavioral, environmental, and biogenetic factors including gender differences, ethnicity and race.
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Çelik, B., E. Sahin, A. Nadir e M. Kaptanoglu. "Iatrogenic Pneumothorax: Etiology, Incidence and Risk Factors". Thoracic and Cardiovascular Surgeon 57, n. 05 (23 luglio 2009): 286–90. http://dx.doi.org/10.1055/s-0029-1185365.
Tesi sul tema "Iatrogenic risk":
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Yoshikawa, Rokusuke. "Risk analysis of iatrogenic endogenous retrovirus infection by vaccination". Kyoto University, 2013. http://hdl.handle.net/2433/175016.
Abstract (sommario):
Kyoto University (京都大学)0048
新制・課程博士
博士(人間・環境学)
甲第17667号
人博第634号
新制||人||153(附属図書館)
24||人博||634(吉田南総合図書館)
30433
京都大学大学院人間・環境学研究科相関環境学専攻
(主査)教授 五十嵐 樹彦, 教授 小松 賢志, 准教授 三浦 智行
学位規則第4条第1項該当
2
Chappell, Lucy Charlotte. "An investigation of vitamin C and E supplementation in women at risk of pre-eclampsia". Thesis, King's College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274935.
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Howlin, Robert. "Decontamination of prions, prion-associated amyloid and infectivity from surgical stainless steel : implications for the risk of iatrogenic transmission of CJD". Thesis, University of Southampton, 2009. https://eprints.soton.ac.uk/150533/.
Abstract (sommario):
The physicochemical nature of the infectious agent in prion diseases creates a significant challenge for decontamination services. It has been shown to be both resistant to standard methods of decontamination, used to inactivate viruses and bacteria, and to associate avidly with surgical stainless steel. Moreover, the pathophysiology of the variant, iatrogenic and sporadic forms of Creutzfeldt-Jakob Disease (CJD) suggests deposition of the infectious agent across a wide range of extraneural, lymphoid tissues, as well as in the skeletal muscle and blood. Coupled with the potential for asymptomatic carriers, there is a significant risk of iatrogenic transmission of CJD through both neurosurgical procedures and standard surgery. This PhD study was undertaken in order to improve methods of instrument decontamination and to evaluate prion detection techniques and their applicability for the assessment of prion inactivation and removal. The project has provided relevant, critical assessment of hospital decontamination procedures, in addition to guidance on how working protocols should be improved to provide a cleaner and safer end product for the patient. Moreover, laboratory studies have been performed to evaluate current methods of prion decontamination in the context of hospital procedures for instrument reprocessing. Challenges faced by sterile service departments, such as soil drying and surface degradation, have been addressed and their impact on the risk of iatrogenic transmission of prions has been investigated. Critically, the use of a fluorescent amyloid fluorophore for the detection of prionassociated amyloid as a marker for disease permitted the investigation of the role of amyloid in infectious disease under denaturing conditions. Correlation of this detection technique with the identification of PrPres by Western blot and infectious disease suggested that, whilst fluorescent detection of prion-associated amyloid was more sensitive than Western blot, PrPres detection was more specific relative to infectivity. Improved fluorophores, with greater sensitivity, have been evaluated which will enhance in situ detection of prions in the future.
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Szlejf, Cláudia. "Eventos adversos médicos em idosos hospitalizados: frequência e fatores de risco em enfermaria de geriatria". Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5144/tde-30112010-152956/.
Abstract (sommario):
Introdução: idosos hospitalizados apresentam maior risco de sofrer eventos adversos na internação que adultos jovens, com consequências mórbidas significativas. O objetivo deste estudo é estimar prospectivamente a freqüência de eventos adversos médicos, os fatores de risco para sua ocorrência e sua relação com óbito intrahospitalar em idosos admitidos aos leitos destinados a cuidados de descompensações clínicas agudas de uma enfermaria de geriatria. Métodos: estudo de coorte prospectivo incluindo as admissões de pacientes com 60 anos ou mais aos leitos destinados a cuidados de descompensações clínicas agudas da Enfermaria de Geriatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, com duração maior de 24 horas, entre abril de 2007 e julho de 2008. Na admissão foram obtidos dados sobre sexo, idade, número de drogas utilizadas, presença de síndromes geriátricas (imobilidade, instabilidade postural, incontinência esfincteriana, demência, depressão e delirium), comorbidades, status funcional (índice de Katz) e gravidade de doença (SAPS II). Durante o período de internação avaliou-se a ocorrência de delirium, infecção, a prescrição de medicamentos inapropriados ao idoso (critérios de Beers) e óbito intrahospitalar. Um observador não envolvido nos cuidados dos pacientes relatou a ocorrência de eventos adversos médicos. Resultados: foram incluídas 171 admissões de pacientes, com idade média de 78,12 anos ± 9,27, sendo 101 do sexo feminino. Ocorreram 187 eventos adversos médicos em 94 admissões (55%), com 2,01 eventos por admissão. Não foi possível identificar fatores preditores da ocorrência de eventos adversos médicos. As admissões com ocorrência de eventos adversos apresentaram maior tempo de internação na enfermaria de geriatria (21,41 dias ± 15,08 X 10,91 dias ± 7,21, p<0,001) e maior mortalidade intra-hospitalar que as admissões onde não houve eventos. Como fatores preditores de mortalidade intra-hospitalar após análise multivariada identificou-se o SAPS II (Razão de chances (OR)=1,13, intervalo de confiança (IC) 95% 1,07-1,20, p<0,001), índice de Katz na admissão (OR=1,47, IC 95% 1,18-1,83, p=0,001) e ocorrência de eventos adverso médico (OR=3,59, IC 95% 1,55-8,30, p=0,003). Conclusões: Eventos adversos médicos devem ser considerados em todo idoso hospitalizado uma vez que são bastante frequentes nessa população. Não há um perfil de risco para indivíduos suscetíveis. Estes eventos apresentam impacto na mortalidade e no tempo de internação.Introduction: hospitalized seniors are at higher risk of adverse events than young adults and it is a morbid condition. The aim of this study is to prospectively estimate the frequency of medical adverse events in elderly patients admitted to an acute care geriatric ward, the predictive factors to its occurrence, and their implication in death during hospitalization. Methods: prospective cohort study including the admissions of elderly patients that lasted more than 24 hours to the acute care session of the geriatric ward in Hospital das Clínicas of Faculdade de Medicina, Universidade de São Paulo, between 2007 and 2008. At admission the variables assessed were age, gender, number of drugs, geriatric syndromes (immobility, postural instability, dementia, depression, delirium and incontinency), comorbidities, functional status (Katz Score), and severity of illness (SAPS II). During hospitalization, the occurrence of delirium, infection, the prescription of potentially inappropriate medications according to Beers criteria and death were assessed. An observer not involved in the patients care reported the medical adverse events. Results: 171 admissions were enrolled in the study, mean age 78.12 ± 9.27 years, 101 females. 187 medical adverse events occurred in 94 admissions (55%), with 2.01 events per admission. Predictors to medical adverse events were not found. Time of hospitalization (21.41 days ± 15.08 X 10.91 days ± 7.21, p<0.001) and mortality (39 (41.5%) X 17 (22.1%), p=0.007) were respectively longer and higher in the admissions with medical adverse events. Death was independently predicted by SAPS II (Odds-ratio (OR)=1.13, Confidence interval (CI) 95% 1.07-1.20, p<0.001), Katz score (OR=1.47, CI 95% 1.18-1.83, p=0.001), and medical adverse events (OR=3.59, CI 95% 1.55-8.30, p=0.003). Conclusion: Medical adverse events shall be sought in every hospitalized older adult since there is not a risk profile of susceptible patients, and its burden is high, leading to death and longer hospital stays.
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Karlsson, Malvina, e Emma Vikholm. "IATROGENT LÄKEMEDELSMISSBRUK : En intervjustudie om sjuksköterskors erfarenheter av att bemöta individer med risk för att utveckla ett iatrogent läkemedelsmissbruk". Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-105326.
Abstract (sommario):
Bakgrund: Iatrogent läkemedelsmissbruk innebär ett skadligt bruk av läkemedel som har orsakats av vården. Tidigare forskning har visat att missbruk av beroendeframkallande läkemedel har ökat under de senaste åren, detta är något som skulle kunna skapa ett större folkhälsoproblem. Som sjuksköterska är det därför viktigt att arbeta för att förebygga och minska risker som kan komma att innebära ett lidande för patienten. Idag saknas det även aktuell forskning som rör detta område ur ett sjuksköterskeperspektiv.Syfte: Studiens syfte är att beskriva sjuksköterskans erfarenheter av att bemöta individer med en risk för att utveckla ett iatrogent läkemedelsmissbruk.Metod: Kvalitativ semistrukturerad intervjustudie med totalt åtta legitimerade sjuksköterskor som arbetade på olika enheter inom hälso- och sjukvården. Materialet analyserades med hjälp av en manifest innehållsanalys.Resultat: Sjuksköterskornas erfarenheter sammanställdes i fyra huvudkategorier samt nio underkategorier. De fyra huvudkategorierna var; Sjuksköterskans professionella roll, Vårdteamets inverkan och Kvalitetsarbetets inverkan.Slutsats: Som sjuksköterska är en vårdande relation med ett personcentrerat förhållningssätt särskilt betydelsefullt och viktigt för att minska lidande vid ett iatrogent läkemedelsberoende. Avsaknaden av regionala och nationella riktlinjer samt tidsbrist är andra väsentliga faktorer som kan påverka det förebyggande arbetet negativt. Idag saknas det även kunskap om beroendeproblematik ur ett sjuksköterskeperspektiv. Det identifierades en kunskapslucka och författarna ser möjligheter i att förbättra det förebyggande arbetet med hjälp bland annat av en mer omfattande utbildning kring ämnet.
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Berthe-Aucejo, Aurore. "Pharmacie clinique en pédiatrie : prescriptions inappropriées". Electronic Thesis or Diss., Université Paris Cité, 2021. http://www.theses.fr/2021UNIP5248.
Abstract (sommario):
Le contexte de la prescription médicamenteuse chez l’enfant est complexe : évolution physiologique et métabolique, prescription hors et sans AMM, formes galéniques non adaptées. Les enfants sont exposés à un risque iatrogène plus important que l’adulte. Un outil de détection des prescriptions inappropriées (POPI : Pédiatrie - Omissions et Prescriptions Inappropriées) a été développé en pédiatrie. Nous avons évalué rétrospectivement la prévalence des prescriptions inappropriées (PI) en ville et à l’hôpital. Le taux de prévalence des PI et des omissions de prescriptions (OP) étaient respectivement de 2,9% et 2,3% aux urgences pédiatriques et 12,3% et 6,1% en ville. L’étude de reproductibilité a permis de constater un excellent accord inter-juge entre les médecins dans la détection des PI et entre les pharmaciens dans la détection des OP. Les PI et les OP avaient une bonne concordance entre les différents professionnels de santé. Enfin, nous avons pu adapter notre outil pour une utilisation internationale en utilisant une méthode Delphi. Sur les 105 critères évalués, 80 critères ont obtenu plus de 75% d’accord après le premier tour, 16 items ont été modifiés et 25 ont été supprimés. L’outil POPI international final est composé de 73 items de PI et d’OP. Les principales raisons de modification ou de suppression étaient des différences entre les recommandations des différents pays et l’indisponibilité du médicament. Ces différents travaux ont permis d’évaluer la prévalence des PI en pédiatrie, de montrer que l’outil est utilisable par différents professionnels. La facilité d’utilisation de l’outil a été approuvée par la majorité des utilisateurs qui étaient prêts à l’utiliser dans leur pratique quotidienne. L’outil doit donc permettre d’aider les professionnels de santé à détecter les PI/OP et d’améliorer la prise en charge médicamenteuse des enfantsThe context of drug prescription in children is complex : physiological evolution and metabolic changes, off-label prescription, unsuitable dosage forms. Children are at greater iatrogenic risk than adults. A tool for detecting inappropriate prescriptions in paediatrics (POPI : Paediatric - Omission Prescriptions and Inappropriate prescriptions) has been developed. We retrospectively evaluated the prevalence of inappropriate prescriptions (IP) in community setting and in hospital. The prevalence of IP and omitted prescriptions (OP) were respectively 2.9% and 2.3% in emergency department and 12.3% and 6.1% in community setting. The reproducibility study showed excellent inter-judge agreement between doctors in the detection of IP and between pharmacists in the detection of OP. The IP and OP had a good agreement between the different healthcare professionals. Finally, we proposed an adaptation of our tool for use in worldwide. Of the 105 criteria evaluated, 80 criteria obtained more than 75% agreement after the first round, 16 items were modified and 25 were deleted. The final international POPI tool is composed of 73 IP and OP. The main reasons for modification or deletion were differences between the recommendations of the different countries and the unavailability of the drug. This work has allowed us to assess the prevalence of IP in paediatrics and to show that the tool is usable by different professionals. The ease of use of the tool was approved by the majority of users and they were ready to use it in their daily practice. This tool can help healthcare professionals to detect IP/OP and improve the medication management of children
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Bertin, Célian. "Évaluation pharmacoépidémiologique des Troubles de l’usage du sulfate de morphine". Thesis, Université Clermont Auvergne (2017-2020), 2020. http://theses.bu.uca.fr/nondiff/2020CLFAC016_BERTIN.pdf.
Abstract (sommario):
La prescription d’antalgiques opioïdes a fortement augmenté ces dix dernières années dans la plupart des pays industrialisés. Cette inflation s’est logiquement accompagnée d’un accroissement des complications iatrogènes de ces molécules, aux premiers rangs desquels les problématiques de dépendance, de trouble de l’usage, d’intoxications involontaires et parfois de décès. La France paraît, à l’heure actuelle, globalement préservée de ce qui est désormais qualifié de « crise des opioïdes », grâce à sa réglementation stricte sur la prescription et la délivrance de ces molécules, dont la plupart sont classées comme stupéfiants. Toutefois, le dernier rapport (2019) « État des lieux de la consommation des antalgiques opioïdes et leurs usages problématiques » de l’Agence Nationale de Sécurité du Médicament et des produits de santé, pointe l’existence de signaux d’alerte sur un opioïde spécifique : « le sulfate de morphine est l’antalgique opioïde fort le plus consommé en ville et ayant le taux de notifications le plus important ; en particulier la spécialité Skénan® qui représente 81 % des notifications ». Ces alertes ciblaient particulièrement deux populations de patients, auxquels les deux premières parties de ce travail de recherche vont se consacrer.La première partie de ce travail s’est attachée à évaluer l’usage de sulfate de morphine hors Autorisation de Mise sur le Marché dans un contexte de trouble de l’usage d’opioïdes comme médicament de substitution alternatif aux traitements conventionnels (buprénorphine ou méthadone), ou en remplacement de l’héroïne. La prévalence de cet usage alternatif restait méconnue, tout comme les caractéristiques sociodémographiques et sanitaires de ces patients et les complications auxquels cet usage pouvait les exposer. L’évaluation de ces risques revêt une importance particulière, la galénique à libération prolongée du Skénan® étant décrite par les études antérieures comme fréquemment altérée pour être injectée par voie intraveineuse, majorant les risques de surdose et de complications infectieuses, mais aussi thrombotiques. L’utilisation d’approches pharmacoépidémiologiques sur bases de données exhaustives de remboursements de l’Assurance Maladie a permis de montrer que l’usage régulier de morphine, à la manière d’un médicament de substitution, ne concernait qu’une minorité de patients (1,0 %), rapporté à l’ensemble de ceux concernés par un trouble de l’usage d’opioïde. Toutefois, ces usagers encourraient un risque de surdose dans l’année suivant l’instauration de la morphine 3,8 et 2 fois supérieur aux témoins qui débutaient, respectivement, de la buprénorphine ou de la méthadone. Les risques de décès, de mésusage, et d’infections bactériennes étaient aussi augmentés, tandis que leur situation sociale et sanitaire générale paraissait plus précaire, avec des comorbidités accrues par rapport aux témoins. La deuxième partie de ce manuscrit s’est consacrée aux patients souffrant de douleurs chroniques, recevant des prescriptions régulières et persistantes de sulfate de morphine oral dans ce contexte. Les données de pharmacovigilance indiquent qu’un certain nombre d’entre eux ont développé un trouble de l’usage d’opioïdes secondaire iatrogène au sulfate de morphine, pouvant s’accompagner d’intoxications involontaires. En l’absence de données françaises concernant la prévalence des surdoses et troubles de l’usage de morphine chez les patients douloureux chroniques avec et sans dépendance aux opioïdes, nous avons conduit une étude pharmacoépidémiologique dont nous avons comparé les résultats avec ceux de témoins dépendants non-douloureux. En France, en 2015, 16 665 patients douloureux chroniques bénéficiant de délivrances régulières de sulfate de morphine ont été identifiés, parmi lesquels 905, soit 5,4 %, présentaient un trouble de l’usage d’opioïdes comorbide à leurs douleurs. (...)Opioid analgesic prescriptions have increased significantly over the past decade in most industrialized countries. This inflation has logically been accompanied by an increase in complications related to the iatrogenicity of these drugs, primarily problems of dependence, use disorders, unintentional intoxication and, in some cases, death. Today, France appears to have been spared from what is now called the ‘opioid crisis’, due to its strict regulations on the prescription and dispensing of these drugs, which are mostly classified as narcotics. However, the latest report (2019): ‘Use and Abuse of Opioid Analgesics’ from the National Agency for the Safety of Medicines and Health Products: ’Morphine sulfate is the most consumed strong opioid analgesic supplied by high street pharmacies, and has the highest rate of notifications, in particular concerning the product Skénan® which represents 81% of notifications.’ These alerts particularly targeted two patient populations, to which the first two parts of this research work will be focused.The first part of this work focused on evaluating the use of morphine sulfate outside the scope of the Marketing Authorization in the context of opioid use disorders as an alternative to conventional treatments (buprenorphine or methadone), or as a replacement for heroin. The prevalence of this alternative use remained unknown, as did the sociodemographic and health characteristics of these patients and the complications to which this use could expose them. The assessment of these risks is of particular importance, as the sustained-release galenic form of Skénan® has been described by previous studies as frequently altered to be injected intravenously, increasing the risks of overdoses and infectious as well as thrombotic complications. The use of pharmacoepidemiological approaches based on exhaustive French health insurance reimbursement databases has shown that regular use of morphine, as a substitution therapy, concerned only a minority of patients (1.0%) out of all those affected by opioid use disorders. However, these users would be at 3.8- and 2.0-times greater risk of overdose within one year after starting morphine than controls who started buprenorphine or methadone, respectively. The risks of death, misuse, and bacterial infections were also increased, while their overall social and health status appeared more vulnerable, with increased comorbidities compared to controls.The second part of this manuscript was focused on patients suffering from chronic pain, receiving regular and persistent oral morphine sulfate prescriptions in this context. Pharmacovigilance data indicate that a number of them have developed opioid use disorders secondary to morphine sulfate iatrogenicity, which may be accompanied by unintentional intoxication. In the absence of French data concerning the prevalence of overdoses and morphine use disorders in chronic pain patients with and without opioid dependence, we conducted a pharmacoepidemiological study comparing the results with those of non-pain dependent controls. In the absence of French data concerning the prevalence of overdoses and morphine use disorders in chronic pain patients with and without opioid dependence, we conducted a pharmacoepidemiological study comparing the results with those of non-pain dependent controls. In France, in 2015, 16,665 chronic pain patients benefiting from regular morphine sulfate dispensing were identified, of whom 905, i.e. 5.4%, presented an opioid use disorder comorbid to their pain. Among the latter, the prevalence of overdose hospitalizations was 6.0-times higher than that of pain non-dependent patients and twice that of pain dependent controls. The social and health characteristics of these pain-dependent patients were at the interface between those of the painful non-dependent, less vulnerable, and the painless non-dependent, more deprived. (...)
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Willemyns, Amanda Jo-Anne. "Under the carpet : the politics and trauma of patient harm". Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/46266/1/Amanda_Willemyns_Thesis.pdf.
Abstract (sommario):
Few studies have investigated iatrogenic outcomes from the viewpoint of patient experience. To address this anomaly, the broad aim of this research is to explore the lived experience of patient harm. Patient harm is defined as major harm to the patient, either psychosocial or physical in nature, resulting from any aspect of health care. Utilising the method of Consensual Qualitative Research (CQR), in-depth interviews are conducted with twenty-four volunteer research participants who self-report having been severely harmed by an invasive medical procedure. A standardised measure of emotional distress, the Impact of Event Scale (IES), is additionally employed for purposes of triangulation. Thematic analysis of transcript data indicate numerous findings including: (i) difficulties regarding patients‘ prior understanding of risks involved with their medical procedure; (ii) the problematic response of the health system post-procedure; (iii) multiple adverse effects upon life functioning; (iv) limited recourse options for patients; and (v) the approach desired in terms of how patient harm should be systemically handled. In addition, IES results indicate a clinically significant level of distress in the sample as a whole.
To discuss findings, a cross-disciplinary approach is adopted that draws upon sociology, medicine, medical anthropology, psychology, philosophy, history, ethics, law, and political theory. Furthermore, an overall explanatory framework is proposed in terms of the master themes of power and trauma. In terms of the theme of power, a postmodernist analysis explores the politics of patient harm, particularly the dynamics surrounding the politics of knowledge (e.g., notions of subjective versus objective knowledge, informed consent, and open disclosure). This analysis suggests that patient care is not the prime function of the health system, which appears more focussed upon serving the interests of those in the upper levels of its hierarchy.
In terms of the master theme of trauma, current understandings of posttraumatic stress disorder (PTSD) are critiqued, and based on data from this research as well as the international literature, a new model of trauma is proposed. This model is based upon the principle of homeostasis observed in biology, whereby within every cell or organism a state of equilibrium is sought and maintained. The proposed model identifies several bio-psychosocial markers of trauma across its three main phases. These trauma markers include: (i) a profound sense of loss; (ii) a lack of perceived control; (iii) passive trauma processing responses; (iv) an identity crisis; (v) a quest to fully understand the trauma event; (vi) a need for social validation of the traumatic experience; and (vii) posttraumatic adaption with the possibility of positive change.
To further explore the master themes of power and trauma, a natural group interview is carried out at a meeting of a patient support group for arachnoiditis. Observations at this meeting and members‘ stories in general support the homeostatic model of trauma, particularly the quest to find answers in the face of distressing experience, as well as the need for social recognition of that experience. In addition, the sociopolitical response to arachnoiditis highlights how public domains of knowledge are largely constructed and controlled by vested interests. Implications of the data overall are discussed in terms of a cultural revolution being needed in health care to position core values around a prime focus upon patients as human beings.
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Gallotti, Renata Mahfuz Daud. ""Eventos adversos e óbitos hospitalares em serviço de emergências clínicas de um hospital universitário terciário: um olhar para a qualidade da atenção"". Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/5/5159/tde-15082005-171758/.
Abstract (sommario):
Eventos adversos (EAs), definidos como complicações não intencionais decorrentes do cuidado prestado, são reconhecidos como um dos maiores problemas na área da saúde. Embora a maior parte dos eventos acarrete incapacitações leves, uma proporção considerável está relacionada à morte de pacientes. O atendimento de urgência é considerado importante fator de risco para o desencadeamento destas complicações. No Brasil, estudos relacionados a este tema não foram publicados até o momento. O presente estudo objetivou identificar a ocorrência de EAs em pacientes admitidos por acidente vascular cerebral (AVC) ao Pronto-Socorro de Clínica Médica (PSM) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) e determinar as categorias de EAs associadas a óbito. Este estudo caso-controle pareado envolveu 468 pacientes admitidos por AVC ao PSM-HCFMUSP no período de março de 1996 a setembro de 1999. O grupo-caso compreendeu 234 óbitos hospitalares consecutivos e o grupo-controle 234 pacientes que receberam alta, pareados pelo diagnóstico provisório e pela época de internação. Eventos adversos, detectados por revisão de prontuários, foram classificados segundo sua gravidade, causas imediatas, sistemas acometidos e categorias profissionais envolvidas no cuidado aos pacientes. A associação com óbito foi analisada por regressão logística multivariada condicional, incluindo variáveis relacionadas a aspectos demográficos, gravidade do quadro inicial e características da assistência. Nos 468 pacientes foram identificados 1.218 EAs: 932 EAs (76,5%) em 170 casos e 286 EAs (23,5%) em 125 controles. Eventos adversos major corresponderam a 54,1% do total de eventos, com 659 episódios: 538 eventos em 143 casos e 121 em 65 controles. Os procedimentos diagnósticos e terapêuticos e os cuidados de enfermagem foram responsáveis em conjunto por 55,2% do total de eventos. Em relação ao tipo de sistema afetado, 46,0% dos EAs identificados ocasionaram manifestações gerais. Eventos adversos relacionados à enfermagem e EAs médicos representaram as categorias profissionais de EAs mais freqüentes (38,4% e 31,0% do total de eventos). Uma associação significante com óbito foi encontrada em relação a EAs major, EAs médicos e infecções hospitalares, com valores de OR ajustado estimados em 3,72 (IC 95% = 1,63-8,48), 3,69 (IC 95% = 1,60-8,50) e 3,20 (IC 95% = 1,20-8,51), respectivamente. Em resumo, eventos adversos, na sua maioria graves, foram freqüentes em casos e controles, determinando predominantemente manifestações gerais. Os procedimentos diagnósticos e terapêuticos e os cuidados de enfermagem corresponderam às principais causas imediatas de EAs. Em relação à categoria profissional envolvida, os EAs relacionados à enfermagem e os eventos médicos predominaram. Eventos adversos major, EAs médicos e as infecções hospitalares associaram-se de maneira significante com óbito em pacientes com AVC admitidos ao Pronto-Socorro de Clínica Médica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloAdverse events (AEs), defined as unintended injuries caused by medical care, are recognized as a major health problem. Although most of them lead to minimal impairments, a considerable proportion is related to patients death. Urgent care is considered an important AE risk factor. No related Brazilian studies were published so far. The present study aimed to identify the occurrence of AEs in patients admitted for stroke to the medical emergency department of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) and to determine the AEs categories associated to death. This paired case-control study enrolled 468 patients admitted for stroke to the HCFMUSP medical emergency department from March 1996 to September 1999. The cases comprised 234 consecutive deaths and the controls 234 discharged patients, matched for primary diagnosis and admission period. AEs, detected by retrospective chart review, were classified with regard to their severity, immediate causes, affected systems and professional involved in patient care. The association with death was analyzed by multivariate conditional regression including variables related to demographic aspects, clinical severity on admission and care characteristics. A total of 1,218 AEs were identified in 468 patients: 932 AEs (76.5%) in 170 cases and 286 AEs (23.5%) in 125 controls. Major AEs corresponded to 54.1% of all AEs, with 659 episodes: 538 events in 143 cases and 121 in 65 controls. Diagnostic and therapeutic procedures and nursing activities accounted together for 55.2% of all events. Concerning the affected system, 46.0% of the identified AEs lead to general manifestations. Nursing and medical AEs represented the most frequent professional categories involved (38.4% and 31.0% of all events). A significant association with death was found regarding major AEs, medical AEs and nosocomial infections, with adjusted OR estimates of 3.72 (95% IC = 1.63-8.48), 3.69 (95% IC = 1.60-8.50) and 3.20 (95% IC = 1.20-8.51), respectively. In summary, adverse events, most of them severe, were frequent in cases and controls, leading mainly to general manifestations. Diagnostic and therapeutic procedures and nursing activities corresponded to the main AEs immediate causes. Regarding the professional involved, AEs related to nurses and physicians predominated. Major AEs, medical AEs and nosocomial infectious were significantly associated to death in stroke patients admitted to the medical emergency department of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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Servais-Walenda, Sophie. "La maternité avec risques : une analyse ethnographique des risques autour de la procréation au Burkina Faso". Thesis, Montpellier, 2018. http://www.theses.fr/2018MONTT056/document.
Abstract (sommario):
Les politiques de santé de la mère et de l’enfant qui se succèdent dans les pays du Sud depuis trois décennies sont basées sur une approche quantitative du risque autour de la procréation. Elles induisent une vision homogène des situations vécues par les femmes. Au contraire, l’approche anthropologique définit le risque comme un construit social. Elle considère que les populations évaluent et priorisent les risques qui les concernent de façon pertinente. Notre recherche étudie, à partir de la parole des femmes et de leur expérience, quels risques autour de la procréation les préoccupent, et quelle est la place du risque VIH parmi ces risques.Notre approche s’appuie sur une enquête ethnographique de longue durée au Burkina Faso, à Bobo-Dioulasso et dans sa région. Nous avons réalisé des entretiens formels et informels auprès des femmes, leur entourage et des informateurs clé. Des observations de contexte en milieu urbain et rural complètent le corpus de données.Nos résultats montrent une forme de banalisation du risque de VIH/sida dans ses aspects biocliniques. Néanmoins, bien que moins visible, la stigmatisation persiste, la maladie constituant toujours une menace dans sa dimension sociale. Analysant les conditions de vie et de travail des femmes pauvres, nos résultats mettent en évidence une exposition au risque articulé au travail féminin, en zone rurale et en ville. Ils montrent précisément le risque lié à l’usage courant et intensif des pesticides qui inquiète particulièrement les femmes. De plus, notre recherche montre comment le système de santé constitue une menace de l’avis des femmes. Cette perception du risque inhérent aux soins s’inscrit dans un contexte plus large de « crise de confiance », à l’égard du système de soins qui crée des « mal traitances », notamment chez les femmes pendant leur grossesse.Cette recherche doctorale rend visible au Burkina Faso des risques perçus par les femmes négligés et « non calculés » par le système de soins. Elle participe à l’inscription des risques liés à l’environnement et aux conditions de travail informel comme des problèmes majeurs de santé publique qui affectent la mère et l’enfant en Afrique de l’OuestSuccessive Maternal and Child Health policies during last three decades in the Global South were based on a quantitative approach to reproductive risk, with a homogeneous vision of women's life experiences. On the contrary, the anthropological approach defines risk as a social construction and considers that populations assess and prioritize their exposure risks in a relevant manner.Our approach is based on a long-term ethnographic study in Bobo-Dioulasso (Burkina Faso) and its environment. We conducted formal and informal interviews with women, their families and key informants. Contextual observations in urban and rural areas complete the data set.Our results show a form of trivialization of HIV/AIDS risk in its bioclinical aspects. However, although less visible, stigma is persisting, and the social dimension of disease are still a threat. Our research describes the living and working conditions of poor women. It highlights their exposure to risk related to women's work in both rural areas and cities. It specifically examines the risk associated with the current intensive use of pesticides, which particularly concern women.In addition, our research shows how women perceive the healthcare system as a threat. This perception of risk related to care is part of a broader context of « crisis of confidence » in the health care system that creates « mistreatments », especially among pregnant women.This doctoral research reveals the neglected and « not quantified » risks perceived by women. It contributes to the recognition of environment related risks and informal working conditions as major public health problems affecting mothers and children in West Africa
Libri sul tema "Iatrogenic risk":
1
P, Coleman Michel, a cura di. Cancer risk after medical treatment. Oxford: Oxford University Press, 1991.
2
Orlikoff, James E. Malpractice prevention and liability control for hospitals. 2a ed. Chicago, Ill: American Hospital Pub., 1988.
3
Orlikoff, James E. Malpractice prevention and liability control for hospitals. Chicago, Ill: American Hospital Pub., 1985.
4
Robin, Eugene Debs. Medical care can be dangerous to your health: A guide to the risks and benefits. New York: Perennial Library, 1986.
5
E, Starzl Thomas. The puzzle people: Memoirs of a transplant surgeon. Pittsburgh: University of Pittsburgh Press, 1992.
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E, Starzl Thomas. The puzzle people: Memoirs of a transplant surgeon. Pittsburgh: University of Pittsburgh Press, 1992.
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E, Starzl Thomas. The puzzle people: Memoirs of a transplant surgeon. Pittsburgh: University of Pittsburgh Press, 2003.
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Turiel, Judith Steinberg. Beyond second opinions: Making choices about fertility treatment. Berkeley: University of California Press, 1998.
9
Miles, J., e Timothy W. R. Briggs. Approaches to the hip. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.007002.
Abstract (sommario):
♦ The development of safe and reliable approaches has allowed hip replacement surgery to be undertaken successfully♦ There are four main approaches, each with their inherent advantages and disadvantages♦ Awareness of the structures at risk with each approach reduces the risk of iatrogenic injury♦ All of the approaches have been modified and improved upon to address specific weaknesses.
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Oliver, Jennifer, e K. Annette Mizuguchi. Pneumothorax. A cura di Matthew D. McEvoy e Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0021.
Abstract (sommario):
This chapter examines the diagnosis and management of an unexpected pneumothorax in a patient undergoing general anesthesia. It reviews the mechanisms and risks associated with development of a pneumothorax in the perioperative period, further characterizing the various types of pneumothoraces, including spontaneous, traumatic, and iatrogenic pneumothorax. General anesthesia can alter many of the presenting signs and symptoms normally associated with the development of a pneumothorax, making diagnosis difficult. These variances are discussed, and information regarding the step by step management of a tension pneumothorax is included. It also describes common procedures associated with an increased risk of developing a pneumothorax.
Capitoli di libri sul tema "Iatrogenic risk":
1
Kearsley, Richard B. "Iatrogenic Retardation: A Syndrome of Learned Incompetence". In Infants at Risk, 153–80. London: Routledge, 2021. http://dx.doi.org/10.4324/9781003171447-6.
2
Niv, Yaron, e Yossi Tal. "The Scope of Iatrogenic Harm". In Patient Safety and Risk Management in Medicine, 11–14. Cham: Springer Nature Switzerland, 2023. http://dx.doi.org/10.1007/978-3-031-49865-7_2.
3
Widdowson, Mark. "Reducing THE RISK OF IATROGENIC SHAMING". In Transactional Analysis, 245–48. 2a ed. London: Routledge, 2023. http://dx.doi.org/10.4324/9781003375890-71.
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Flisher, Denise, e Marilyn Burn. "Nurse Diagnosed Myocardial Infarction - Hidden Nurse Work and Iatrogenic Risk". In Limiting Harm in Health Care: A Nursing Perspective, 171–93. Oxford, UK: Blackwell Science Ltd, 2008. http://dx.doi.org/10.1002/9780470774502.ch9.
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Irvine, Lucy C. "Selling Beautiful Births: The Use of Evidence by Brazil’s Humanised Birth Movement". In Global Maternal and Child Health, 199–219. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-84514-8_11.
Abstract (sommario):
AbstractMaternal health care continues to be excessively medicalised in many national health systems. Global, national, and local level policy initiatives seek to normalise low-risk birth and optimise the use of clinical interventions, informed by strong evidence supporting care that is centred on women’s preferences and needs. Challenges remain in translating evidence into practice in settings where care is primarily clinician-led and hospital-based, such as in Brazil.I conducted an ethnography of the movement for humanised care in childbirth in São Paulo between 2015 and 2018. I draw on interviews and focus groups with movement members (including mothers, doulas, midwives, obstetricians, politicians, programme leads, and researchers), and observations in health facilities implementing humanised protocols, state health council meetings, and key policy fora (including conferences, campaigning events, and social media). Key actors in this movement have been involved in the development and implementation of evidence-based policy programmes to “humanise” childbirth. Scientific evidence is used strategically alongside rights-based language, such as “obstetric violence”, to legitimise moral and ideological aims. When faced with resistance from pro-c-section doctors, movement members make use of other strategies to improve access to quality care, such as stimulating demand for humanised birth in the private health sector. In Brazil, this has led to a greater public awareness of the risks of the excessive medicalisation of birth but can reinforce existing inequalities in access to high-quality maternity care. Lessons might be drawn that have wider relevance in settings where policymakers are trying to reduce iatrogenic harm from unnecessary interventions in childbirth and for supporters of normal birth working to reduce barriers to access to midwifery-led, woman-centred care.
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Ireland, A. J., e Fraser McDonald. "Iatrogenic problems". In The Orthodontic Patient: Treatment and Biomechanics, 309–30. Oxford University PressOxford, 2003. http://dx.doi.org/10.1093/oso/9780198510482.003.0012.
Abstract (sommario):
Abstract As a profession we must undertake, wherever possible, to minimize harm to our patients. In a specialty such as orthodontics, which is based largely on improving aesthetics and where there is limited evidence for any increased longevity of the dentition as a result of treatment, we must ensure that the long-term prognosis of teeth is not adversely compromised. At each stage it is essential that consideration be given to the fact that orthodontic treatment can cause damage to a number of tissues. It is fortunate that, in general, such damage is so minimal as to be clinically insignificant with little effect on the long-term prognosis of the dentition. It is a matter of clinical judgement when this damage, or the risk of such damage, outweighs the benefits to be gained by the treatment.
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"Iatrogenic multiple pregnancy: the risk of ART". In Textbook of Assisted Reproductive Techniques, 1111–29. CRC Press, 2001. http://dx.doi.org/10.1201/9781439813942-63.
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"Iatrogenic multiple pregnancies: The risk of ART". In Textbook of Assisted Reproductive Techniques, 424–35. CRC Press, 2012. http://dx.doi.org/10.3109/9781841849737-36.
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Blickstein, Isaac. "Iatrogenic multiple pregnancies: The risk of ART". In Textbook of Assisted Reproductive Techniques, Volume Two: Clinical Perspectives, 382–93. Informa Healthcare, 2012. http://dx.doi.org/10.3109/9781841849737.063.
10
"12: General Approach to Risk Reduction". In Diabetes Risks from Prescription & Non Prescription Drugs: Mechanisms and Approaches to Risk Reduction, 107–18. American Diabetes Association, 2016. http://dx.doi.org/10.2337/9781580406192.12.
Abstract (sommario):
The first step toward reduction of the risk of iatrogenic hyperglycemia is a thoughtful evaluation of the indications for any prescription, which should be based on compelling evidence. Whenever feasible, medications of proven efficacy on the primary condition that exhibit a low risk for dysglycemia should be given preference, particularly in high-risk individuals.
Atti di convegni sul tema "Iatrogenic risk":
1
Rothman, A., e Y. I. Lee. "Risk Factors of Iatrogenic Pneumothorax in Patients Undergoing Transthoracic Needle Biopsies". In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a4191.
2
Chakraborty, D., M. A. Mitchell e I. Dhaliwal. "Assessing the Risk of Iatrogenic Pneumothorax Based on Location of Transbronchial Lung Biopsy". In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a2412.
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Quigley, Ryan J., Hideya Ishigooka, Michelle H. McGarry, Yu J. Chen, Akash Gupta, Chris Bui e Thay Q. Lee. "Anatomical Posterolateral Corner Reconstruction of the Knee Using a New Fibula Cross Tunnel Method: A Cadaveric Study". In ASME 2010 5th Frontiers in Biomedical Devices Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/biomed2010-32041.
Abstract (sommario):
Posterolateral corner (PLC) injury of the knee causes varus and posterolateral rotatory instability. The anatomy of the PLC has been reported in the literature but the importance of PLC reconstruction has only recently been established and ideal reconstruction techniques are still in development. The native function of the PLC is to restrain varus and external rotation. Reconstruction methods should properly restore these functions without overconstraining the joint. Several reconstructions for PLC injury have been reported but with concerns of iatrogenic neurovascular injury, fibular head cutout, and restoration of the knee kinematics. To address these concerns, a new cross fibula tunnel method was developed that may have lower risk of iatrogenic nerve injury and fibula head cutout. The purpose of this study was to verify the stability of this technique using a PLC deficient knee.
4
Arcizet, J., B. Leroy, C. Renzullo, JM Doise e J. Coutet. "PS-042 For better iatrogenic lactic acidosis prevention: let’s manage its risk factors better!" In 22nd EAHP Congress 22–24 March 2017 Cannes, France. British Medical Journal Publishing Group, 2017. http://dx.doi.org/10.1136/ejhpharm-2017-000640.548.
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Parezova, Michaela, Vladimir Herout, Ivan Cundrle e Kristian Brat. "Transbronchial biopsy from the upper lobes is associated with increased risk of iatrogenic pneumothorax." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa4189.
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Tsai, Andrew G., Timothy Ashworth e Ozan Akkus. "Strength of Materials Based Prediction of Critical Stresses at the Proximal Femur: Validation by Finite Element Analysis". In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14208.
Abstract (sommario):
A small but significant fraction of screw placement in the proximal femur for hip fractures results in iatrogenic fractures associated with the screw hole [1]. There is evidence that the failure occurs under fatigue, and it is likely that those individuals experiencing failure have greater stresses in the proximal femur as dictated by key morphometric variables, such as cortical thickness and bone size. Finite element analysis (FEA) could greatly facilitate fracture risk assessment in the presurgical phase by predicting the local stresses, however, executing FEM in a patient customized fashion would be costly, time consuming, and technically difficult for surgeons to perform.
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Guelli, Mariana Sandoval Terra Campos, Daniela Bastos de Almeida Zampier, Lorena Araújo Silva Dias e Marina de Oliveira Nunes Ibrahim. "Creutzfeldt-Jakob Disease - a literature review". In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.126.
Abstract (sommario):
Background: Creutzfeldt-Jakob disease (CJD) is a progressive, rare, fatal and rapid human neurodegenerative disease that occurs in the etiologies: sporadic (CJD), familial, iatrogenic (CJD) and CJD variant (CJV) in which cell prion protein (PrP) can be transmitted through animals. Objectives: Literature review about Creutzfeldt-Jakob diseaseDesign and setting: Literature review development in the Centro Universitário de Volta Redonda, Rio de Janeiro, Brazil. Methods: The Creutzfeldt-Jakob disease, infectious diseases and neuroinfection indexes were used in the PUBMED and Scielo databases. Results:CJD has different etiologies with different clinical and pathological phenotypes. CJDV shows psychiatric behaviors and symptoms followed by abnormalities, ataxia and dementia. The sporadic form is the most common, with a progressive clinical course with generalized brain deposition of abnormal prion protein aggregates (PrPTSE) that leads to spongiform change, gliosis and neuronal loss. CJD progresses to dementia and two or more symptoms: cerebellar or visual impairments; pyramidal or extrapyramidal signs; myoclonus; and akinetic mutism. Complex periods of acute wave in the electroencephalogram (EEG) are strongly suggestive of prionic diseases. Rapidly evolving field neuroimmune disorders have shown an increasing in autoantibody testing; attempt to diagnose a range of immune-mediated conditions. Evidence indicates that diffusion-weighted magnetic resonance imaging (DWI) is more sensitive for detecting signal abnormalities. Conclusion: The disease progresses to dementia, accompanied by myoclonus, pyramidal signs and characteristic EEG. It is a complex pathology, which has only symptomatic treatment and requires strict control of reservoirs and risk of contamination.
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Rodrigues, Ivon Marcos Inácio, Desiré Dominique Diniz de Magalhães, André de Sá Braga Oliveira, Pablo Mariz de Oliveira e Amanda do Nascimento Oliveira e. Carneiro. "Morphological study of foramen venosum in dry human skulls in Northeast Brazil". In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.394.
Abstract (sommario):
Introduction: The foramen venosum (FV) is located in the larger wing of the sphenoid bone and allows the passage of emissary veins that help to balance the intra and extracranial pressure. Knowledge of its morphology and associated structures has an important surgical value. Objective: Analyze the morphology of FV and its relation to adjacent foramina in Northeast Brazil. Methods: 117 human adult skulls of Federal University of Paraíba were classified by gender, FV type and laterality, being evaluated the diameter of FV, foramen ovale (FO) and foramen spinosum (FS), as well as the distance of FO and FS to FV (DFVFO and DFVFS). Values of p≤0.05 were considered significant. Results: 52 (44.4%) skulls (65 sides, 29 on the right and 36 on the left) presented FV, being 63.46% females and 36.53% males. 33.3% of FV were unilateral and 11.1% were bilateral. The FV were mostly oval (50.7%) and round (49.3%) types. Mean diameter of FV was 3.56±0.7mm, FO 7.88±1.16mm, FS 4.01±0.39mm, DFVFO 8.18±1.09mm and DFVFS was 14.54±1.68mm. Only FO (p=0.009) and FS (p=0.001) had significant differences between genres, and DFVFO had among sides (p=0.021). Conclusions: FV has a high incidence in Northeast Brazil, predominantly in females on the left side with oval and round types. Its relation with other foramina showed differences among genres and sides. This shows the relevance of the FV study to minimize the risk of iatrogenic injury during surgical interventions in this region.
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Zhou, Haoyin, Ryan Bartholomew, Maud Boreel, Alejandro Garcia, Krish Suresh, Saksham Gupta, Jeffrey Guenette, Daniel Lee, C. Eduardo Corrales e Jayender Jagadeesan. "SLAM-based Trackerless Navigation System for Lateral Skull base Surgery: A Pilot Cadaver Study". In THE HAMLYN SYMPOSIUM ON MEDICAL ROBOTICS. The Hamlyn Centre, Imperial College London London, UK, 2023. http://dx.doi.org/10.31256/hsmr2023.2.
Abstract (sommario):
Lateral skull base surgery requires drilling near del- icate structures with high accuracy. Misidentification of anatomy within the opaque temporal bone can lead to inadvertent surgical complications with high morbidity including facial paralysis, hearing loss, and dysequi- librium. Given that benign pathology is typically the indication for surgery, it is of elevated importance for the lateral skull base surgeon to deftly tread the line between underexposure, which risks persistent disease, and overexposure, which risks iatrogenic injury. The safety and efficacy of lateral skull base surgery may be improved with a viable surgical navigation system. Despite the availability of surgical navigation systems for nearly three decades, they are infrequently used for lateral skull base surgeries. The navigation systems depend on external tracking equipment and can suffer from cumbersome registration and calibration steps, and suffer from metallic interference or line-of-sight issues. Moreover, for lateral skull base surgery, the patient head position may be adjusted intraoperatively and result in a significant registration error.
10
Zhyltsova, Y. V., E. A. Sinevich, N. S. Smolnik e P. R. Khilimonchyk. "ANALYSIS OF MICROELEMENTOSIS FORMATION FACTORS OF ZHODINO’ PRIMARY SCHOOL AGE CHILDREN". In SAKHAROV READINGS 2021: ENVIRONMENTAL PROBLEMS OF THE XXI CENTURY. International Sakharov Environmental Institute of Belarusian State University, 2021. http://dx.doi.org/10.46646/sakh-2021-2-45-48.
Abstract (sommario):
The work analyzes the factors influencing the development of excess, deficiency, or imbalance of macro-and microelements in the organism of 7-10-year-old children living in a large industrial city. Based on a questionnaire survey, it was revealed that the development of natural exogenous microelementosis associated with a lack of B, Mo, Zn, Mn, Se in the soil is subject to more than 80 % of respondents, iodine deficiency - 30 %. The risks of acquiring technogenic microelementosis by the population are possible as a result of the increased content of Pb, Cu, Sn, Cr, Co in the soil, Ni, Sn, Zr, Cr, Cu, Co in the production of meadow and agrophytocenoses, Fe and Mn in the water. More than 40 % of children consume tap water without preliminary preparation, 4 % of families periodically use water from wells. The development of natural endogenous microelementosis is possible in 12-58 % cases, iatrogenic microelementosis - in more than 6 % cases.
Rapporti di organizzazioni sul tema "Iatrogenic risk":
1
Levy, Brittany E., Aaron P. Garrison, Daniel von Allmen, Anthony Kraft e Todd A. Ponsky. Esophageal Foreign Bodies. StayCurrentMD, marzo 2022. http://dx.doi.org/10.47465/sc00002.
Abstract (sommario):
Children less than 5 years old are at high risk for foreign body ingestion or aspiration. Therefore, identifying workup and management principles of foreign body ingestion, in the pediatric population, is necessary for pediatric practitioners. Differentiation of caustic ingestion versus benign ingestion is necessary to determine urgency of management. Plain film X ray imaging can be used to differentiate a button battery versus a coin ingestion, based on the halo sign. The urgency of battery ingestion requires immediate medical attention and endoscopic removal, however treatment with honey during transport may improve outcomes. Perforation can occur via caustic ingestion, sometimes with a delayed presentation. However, the most common cause of esophageal perforation is iatrogenic. In many cases perforation can be managed non operatively if contained and adequately drained.