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Sample records for female patients attending

  1. Prevalence of intimate partner violence and its associated risk factors among Saudi female patients attending the primary healthcare centers in Western Saudi Arabia

    PubMed Central

    Alzahrani, Turki A.; Abaalkhail, Bahaa A.; Ramadan, Iman K.

    2016-01-01

    Objectives: To estimate the prevalence of intimate partner violence (IPV) among female patients, age 18-60 years, attending primary health care centers (PHCCs) and to measure its determinants, and reporting behavior. Methods: A cross-sectional study design using validated, translated, and self-administered questionnaire among 497 Saudi female patients attending PHCCs in Taif, Kingdom of Saudi Arabia (KSA) from January to February 2015 was employed. A 2-stage probability sampling was adopted for selection of PHCCs in the first stage, and then participants in the second stage. Results: The estimated prevalence of IPV during the last year was 11.9%. Predictors of IPV related to abused women included divorced status and divorced parents; while those related to abusers (husbands) included widowed parents, exposure to violence in childhood, and alcohol or drugs addiction. Most of the abused wives (56%) talked regarding their IPV to their families, their husbands’ families (15.2%), or their friends (11.8%); while only a minority (3.3%) complained to the police or to a judge, and no one reported this to a family physician, or to women protection agency. Conclusion: One out of 10 women is a victim of IPV in Taif, KSA. Intimate partner violence is significantly associated with a number of victim and abuser-related psychosocial factors, the detection of which might help screening for individuals at risk. PMID:26739983

  2. Job stress among female flight attendants.

    PubMed

    MacDonald, Leslie A; Deddens, James A; Grajewski, Barbara A; Whelan, Elizabeth A; Hurrell, Joseph J

    2003-07-01

    We evaluated the presence of chronic job stressors among flight attendants (FAs) to examine the relationships between these job stressors and psychological distress and job dissatisfaction. Seventy-three female FAs (90% participation) employed at two commercial airlines completed a detailed questionnaire. Standard questions and scale measures were used to assess job stressors, psychological distress, and job dissatisfaction. The association between job stressors and these outcomes was evaluated using multiple regression analysis. Except for fatigue, distress and job dissatisfaction were moderate to low. Job stressors were found to have a substantive effect on these outcomes, following adjustment for individual factors. Despite moderate-to-low levels of distress and dissatisfaction, targeted efforts to reduce selected job stressors and to enhance social support may be important steps toward improving the well-being and satisfaction of FAs. PMID:12855911

  3. Acoustic mate copying: female cowbirds attend to other females' vocalizations to modify their song preferences.

    PubMed

    Freed-Brown, Grace; White, David J

    2009-09-22

    We conducted a tutoring experiment to determine whether female brown-headed cowbirds (Molothrus ater) would attend to vocalizations of other females and use those cues to influence their own preferences for male courtship songs. We collected recordings of male songs that were unfamiliar to the subject females and paired half of the songs with female chatter vocalizations-vocalizations that females give in response to songs sung by males that are courting the females effectively. Thus, chatter immediately following a song provided a cue indicating that the song was sung by a male who was of high-enough quality to court a female successfully. Using a cross-over design, we tutored two groups of females with song-chatter pairings prior to the breeding season. In the breeding season, we placed the tutored females into sound-attenuating chambers and played them the same songs without the chatter. Females produced significantly more copulation solicitation displays in response to the songs that they had heard paired with chatter than to songs that had not been paired with chatter. This experiment is the first demonstration that females can modify their song preferences by attending to the vocal behaviour of other females. PMID:19535371

  4. Eye drop administration in patients attending and not attending a glaucoma education center

    PubMed Central

    Al-Busaidi, Aisha; Samek, Debbie Anne; Kasner, Oscar

    2016-01-01

    Background: To assess the technique of glaucoma eye drop instillation in patients who have and have not attended glaucoma education sessions. To compare this with their subjective perception of eye drop use and identify factors associated with improved performance. Patients and Methods: An observational study of 55 participants who instill their topical glaucoma medication for more than 1 year. Twenty-five patients attended (A) glaucoma teaching sessions >1 year before the study and were compared to thirty patients who never attended (NA). Patients completed a self-reporting questionnaire. They instilled their eye drop, and the technique was video-recorded digitally and later graded by two masked investigators. The results were analyzed using Fisher's exact test and Chi-square test. Predictors were assessed using logistic regression models. Results: There was no significant difference in overall performance scores between the two groups. Good technique was observed in 16% of (A) group versus 23% (NA) group, (P = 0.498). There was a mismatch between patient's subjective and actual performance. Female gender and higher educational level were found to be predictors of good performance of drop instillation on univariable logistic regression analysis. Conclusion: Glaucoma patients are challenged with eye drop instillation despite receiving education on drop administration. There is a discrepancy between patient's perceptions and observed technique of drop administration. PMID:27013822

  5. Does Sex (Female versus Male) Influence the Impact of Class Attendance on Examination Performance?

    ERIC Educational Resources Information Center

    Cortright, Ronald N.; Lujan, Heidi L.; Cox, Julie H.; DiCarlo, Stephen E.

    2011-01-01

    The "conventional wisdom" is that grades are related to class attendance, i.e., students who attend classes more frequently obtain better grades and class attendance dramatically contributes to enhanced learning. However, the influence of sex (female vs. male) on this relationship is understudied. Furthermore, there have been several studies…

  6. Does sex (female versus male) influence the impact of class attendance on examination performance?

    PubMed

    Cortright, Ronald N; Lujan, Heidi L; Cox, Julie H; DiCarlo, Stephen E

    2011-12-01

    The "conventional wisdom" is that grades are related to class attendance, i.e., students who attend classes more frequently obtain better grades and class attendance dramatically contributes to enhanced learning. However, the influence of sex (female vs. male) on this relationship is understudied. Furthermore, there have been several studies examining the impact of attendance on course grades that challenge the conventional wisdom. To address these issues, we determined the effect of class attendance on examination scores for female and male students enrolled in our undergraduate exercise physiology class of 51 students (20 female students and 31 male students). The experiment was designed not to interfere with the normal conduct of the course. Attendance was recorded in each class, and, although regular attendance was encouraged, it was not required and did not factor into the final grades. The final grade reflected the average days of attendance for female students only. Specifically, female students earning a grade above the class average attended 89 ± 4% of the classes; however, female students earning a grade below the class average attended only 64 ± 6% of the classes. In sharp contrast, there was no difference in the number of classes attended for male students earning grades above or below the class average (84 ± 3% vs. 79 ± 5%). Accordingly, some male students were absent frequently but scored above the class average, whereas other male students attended many classes but scored below the class average. Thus, the influence of regular attendance on examination performance is more important for female students than male students. PMID:22139780

  7. Rehabilitation Needs of Chronic Female Inpatients Attending Day-care in a Tertiary Care Psychiatric Hospital

    PubMed Central

    Waghmare, Avinash; Sherine, Linda; Sivakumar, Thanapal; Kumar, C. Naveen; Thirthalli, Jagadisha

    2016-01-01

    Background: Female patients hospitalized for a long duration in psychiatric hospitals are a special population with unique needs. Aims and Objectives: To assess rehabilitation needs of chronic female inpatients attending psychiatric rehabilitation services in a tertiary care psychiatric hospital. Materials and Methods: Rehabilitation needs of nine chronic female inpatients were assessed with an interview schedule developed by expert consensus. The needs were elicited from the patients. Perspectives of nursing staff, vocational instructors, and treating psychiatrists were also sought. Results and Conclusion: Most patients expressed the need for more incentives for working in day-care, variety in food and grooming items. The nursing staff felt many patients could be placed outside, and the family members should come more frequently to meet them. Vocational instructors felt that patients need more incentives, variety in food and work. Treating psychiatrists said that major barriers in discharging and placing them were nonavailability or poor involvement of family members. Services like supported housing, supported education and supported employment are necessary to cater to their complex needs. PMID:27011400

  8. Attending Rounds: A Patient with Intradialytic Hypotension

    PubMed Central

    2014-01-01

    Intradialytic hypotension is the most common adverse event that occurs during the hemodialysis procedure. Despite advances in machine technology, it remains a difficult management issue. The pathophysiology of intradialytic hypotension and measures to reduce its frequency are discussed. An accurate assessment of dry weight is crucial in all patients on dialysis and especially those patients prone to intradialytic hypotension. The presence of edema and hypertension has recently been shown to be a poor predictor of volume overload. Noninvasive methods to assess volume status, such as whole body and segmental bioimpedance, hold promise to more accurately assess fluid status. Reducing salt intake is key to limiting interdialytic weight gain. A common problem is that patients are often told to restrict fluid but not salt intake. Lowering the dialysate temperature, prohibiting food ingestion during hemodialysis, and midodrine administration are beneficial. Sodium modeling in the absence of ultrafiltration modeling should be abandoned. There is not enough data on the efficacy of l-carnitine to warrant its routine use. PMID:24385517

  9. Invitation Choice Structure Has No Impact on Attendance in a Female Business Training Program in Kenya

    PubMed Central

    Diwan, Faizan; Makana, Grace; McKenzie, David; Paruzzolo, Silvia

    2014-01-01

    Business training programs are a common form of support to small businesses, but organizations providing this training often struggle to get business owners to attend. We evaluate the role of invitation choice structure in determining agreement to participate and actual attendance. A field experiment randomly assigned female small business owners in Kenya (N = 1172) to one of three invitation types: a standard opt-in invitation; an active choice invitation where business owners had to explicitly say yes or no to the invitation; and an enhanced active choice invitation which highlighted the costs of saying no. We find no statistically significant effect of these alternative choice structures on willingness to participate in training, attending at least one day, and completing the course. The 95 percent confidence interval for the active treatment effect on attendance is [−1.9%, +9.5%], while for the enhanced active choice treatment it is [−4.1%, +7.7%]. The effect sizes consistent with our data are smaller than impacts measured in health and retirement savings studies in the United States. We examine several potential explanations for the lack of effect in a developing country setting. We find evidence consistent with two potential reasons being limited decision-making power amongst some women, and lower levels of cognition making the enhanced active choice wording less effective. PMID:25299647

  10. Invitation choice structure has no impact on attendance in a female business training program in Kenya.

    PubMed

    Diwan, Faizan; Makana, Grace; McKenzie, David; Paruzzolo, Silvia

    2014-01-01

    Business training programs are a common form of support to small businesses, but organizations providing this training often struggle to get business owners to attend. We evaluate the role of invitation choice structure in determining agreement to participate and actual attendance. A field experiment randomly assigned female small business owners in Kenya (N = 1172) to one of three invitation types: a standard opt-in invitation; an active choice invitation where business owners had to explicitly say yes or no to the invitation; and an enhanced active choice invitation which highlighted the costs of saying no. We find no statistically significant effect of these alternative choice structures on willingness to participate in training, attending at least one day, and completing the course. The 95 percent confidence interval for the active treatment effect on attendance is [-1.9%, +9.5%], while for the enhanced active choice treatment it is [-4.1%, +7.7%]. The effect sizes consistent with our data are smaller than impacts measured in health and retirement savings studies in the United States. We examine several potential explanations for the lack of effect in a developing country setting. We find evidence consistent with two potential reasons being limited decision-making power amongst some women, and lower levels of cognition making the enhanced active choice wording less effective. PMID:25299647

  11. A psychiatric study of patients attending mehandipur balaji temple.

    PubMed

    Satija, D C; Singh, D; Nathawat, S S; Sharma, V

    1981-07-01

    In the present study 100 cases, randomly selected were studied at famous shrine of Rajasthan, the Mehandipur Balaji. As regards the sociodemographic variables, patients were mainly between 15-39 years of age, 80% were educated, 82% had Urban domicile, 98% were Hindus and Females were 54%. Majority of the visitors being from Northern part of India. Failure of modern treatment and influence of family members and friends were the main motivating factors. Majority of patients were Neurotic (48%), followed by Psychotics (28%). Patients who developed trance (possession) were Neurotics. One quarter of the patients who were mainly psychoneurotics, showed improvement. PMID:22058548

  12. Diseases pattern among patients attending Holy Mosque (Haram) Medical Centers during Hajj 1434 (2013)

    PubMed Central

    Bakhsh, Abdulrahman R.; Sindy, Abdulfattah I.; Baljoon, Mostafa J.; Dhafar, Khalid O.; Gazzaz, Zohair J.; Baig, Mukhtiar; Deiab, Basma A.; Hothali, Fauzea T. Al

    2015-01-01

    Objective: To evaluate the diseases pattern among pilgrims attending the 2 Holy Mosque (Haram) Health Care Centers during the Hajj season 2013 (Hijra 1434). Methods: In this cross-sectional study, data was collected from 2 medical centers located in the Holy Mosque in Makkah city, Saudi Arabia, from the first of Dhul-Hijjah to sixteenth Dhul-Hijjah 1434. The present study was completed in 16 days (6th October to 21st October 2013). Results: Over 16 days, 1008 patients attended the medical centers during Hajj 1434, (2013), out of which 554 (55%) were males and 454 (45%) were females. Most of the patients were Egyptians (n=242, 24%), followed by Saudis (n=116, 11.5%), Pakistani (n=114, 11.3%), Turkish (n=50, 5%), and other nationalities (n=404). According to age distribution, mostly were in the 51-60 years age group (n=237, 23.5%), followed by other age groups. Out of 1008 patients, 842 (83.5%) patients were treated and subsequently discharged, while 166 patients (16.5%) were referred to the tertiary centers. According to the diseases pattern, most of the patients were suffering from respiratory problems (n=177, 17.6%) followed by skin diseases (n=158, 15.7%), gastrointestinal tract (GIT) diseases (n=133, 13.2%), and others. Conclusion: Most of the patients were suffering from respiratory problems followed by skin and GIT diseases, and <25% of patients were referred to tertiary care centers. PMID:26219447

  13. Toothache among dental patients attending a Nigerian secondary healthcare setting.

    PubMed

    Azodo, Clement Chinedu; Ololo, Oritseweyemi

    2013-01-01

    INTRODUCTION. Pain intensity and oral health practices among patients with toothache, a major dental public health problem is necessary information for the formulation of preventive and interventional oral health policies. OBJECTIVE. To assess the pain intensity and oral health practices among dental patients attending a Nigerian secondary healthcare setting with toothache. MATERIALS AND METHODS. This study was a prospective study of adult patients attending the dental clinic of Rasheed Shekoni Specialist Hospital, Dutse, Jigawa State, Nigeria. Interviewer-administered questionnaire which elicited information include demography, pain intensity using visual analogue, tooth brushing behaviour and previous dental treatment was the tool of data collection. RESULTS. The majority of the respondents were males and young adults. More than half (60.5%) of the respondents reported pain of moderate to severe intensity and 42.6% have engaged in self medication for the toothache. More than one-third (34.2%) had experienced the pain for ≥ four weeks and the major factor that prompted the decision to visit dentist were unbearable nature of the pain and sleep disturbances. Almost half (46.2%) of the respondents had previously visited the dentist and the common received treatment was tooth extraction. A total of 57.9% of the respondents indulge in twice-daily tooth cleaning. CONCLUSION. Data from this study revealed that respondents with toothache had history of dental visit and visited dental clinic when the pain is unbearable and disturbed sleep. There is a need for proper patient education at any encounter with dentist. PMID:24589637

  14. Somnambulistic-like behaviour in patients attending a lithium clinic.

    PubMed

    Landry, P; Warnes, H; Nielsen, T; Montplaisir, J

    1999-05-01

    The prevalence of somnambulistic-like behaviour related to treatment with lithium alone or in combination with other psychotropic medications was evaluated in patients attending a lithium clinic. A written questionnaire on somnambulistic-like behaviour was completed by 389 patients. Information was provided on the time of occurrence, frequency and severity of the episodes, the presence of childhood somnambulism, and the temporal relationship between psychiatric treatment and somnambulistic-like behaviour. Twenty-seven (27) patients (6.9%) presented sleepwalking behaviour related to the onset of treatment with lithium alone or in combination with other psychotropic drugs. Forty-five patients (11.6%) reported childhood somnambulism and 12 of them (27%) had their childhood somnambulism reactivated by the medication. Most patients had a diagnosis of bipolar affective disorder but somnambulistic-like behaviour also occurred in patients with other axis 1 diagnosis. Sleep-related violence was seldomly reported. Therefore, lithium alone or in combination with other psychotropic drugs may induce somnambulistic-like behaviour. A history of childhood somnambulism may increase the risk of developing sleepwalking behaviour while under psychotropic drugs treatment. PMID:10435770

  15. Patient characteristics affecting attendance at general outpatient clinics.

    PubMed Central

    McClure, R J; Newell, S J; Edwards, S

    1996-01-01

    A study was carried out to identify the characteristics of children who do not attend appointments at general outpatient clinics. Over six months, 359 children who had an appointment at a general clinic were studied using a questionnaire given to parents (74% response rate) and by inspection of case notes. Based on their first appointment in the study period, children were divided into 'attenders' (n = 262) and 'non-attenders' (n = 97) for analysis. Non-attenders were significantly more likely to have one or more of the following characteristics: lower social class, poorer housing, unmarried parent(s) (56% v 33%), longer journey to clinic (35 v 27.6 minutes), more appointments per year (4.2 v 3.3), poorer past attendance record, and received their appointment by post (76% v 44%). Surprisingly parents of non-attenders rated their children to have a significantly more severe illness than those who attended. These results suggest that attendance is primarily determined by social and logistical factors as well as appointment details, rather than illness severity. PMID:8660073

  16. Are unintentional nurse-attended deliveries a patient safety issue?

    PubMed

    Veltman, Larry

    2016-08-01

    Unintentional nurse-attended deliveries occur on most labor and delivery units. Some precipitous deliveries are unavoidable, but others, occurring after admission with the expectation that the woman's designated provider would attend the delivery are, for a variety of reasons, still attended only by nursing staff. This study was undertaken to establish a benchmark for unintentional nurse-attended deliveries. Fifty perinatal units were studied with respect to their statistics regarding unintentional nurse-attended deliveries. Ten of the 50 perinatal units (20%) did not keep statistics on unintentional nurse-attended deliveries. The average percentage of unintentional nurse-attended deliveries in the 40 perinatal units that did keep this statistic was 1.38% (range 0-5.3%). This benchmark should be useful as the safety issues for these types of deliveries are analyzed. Audits regarding timing of examinations during labor, practices regarding notification of providers and other communication practices, provider arrival times, and involved personnel should help perinatal units develop policies, protocols, and strategies to minimize the chances for unintentional nurse-attended deliveries when there should be enough time and appropriate communication to allow the woman's provider to be present at the delivery. PMID:27547875

  17. Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

    PubMed Central

    Hokkam, Emad; Gonna, Abdelaziz; Zakaria, Ossama; El-shemally, Amany

    2015-01-01

    BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital (JGH) in the southwest corner of Saudi Arabia. METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies. RESULTS: The mean age of the patients was 25.3±16.8 years. Most (45.1%) of the patients were at age of 18–30 years. Males (64.3%) were affected by trauma more common than females. More than half (60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury (60%), followed by blunt trauma (30.9%) and then penetrating trauma (9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority (48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%. CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority. PMID:25802567

  18. Depression and its associated factors among patients attending chronic disease clinics in southwest Trinidad.

    PubMed

    Maharaj, R G; Reid, S D; Misir, A; Simeon, D T

    2005-12-01

    This study determined the prevalence of depression and associated factors, among patients attending chronic disease clinics in Southwest Trinidad. This was a cross-sectional survey using a sample of consecutive patients at four large clinics. To determine the presence of depression, an interviewer-applied modified Zung Scale was validated The modified Zung scale, at the cut-off index of 60, has a sensitivity of 60% and a specificity of 94%. Seven hundred and thirty-four completed questionnaires were received, a response rate of 76%. The patients were primarily Indo-Trinidadian (70%), over 50 years (76.4%) and female (72.3%). The prevalence of depression was 28.3%. There were statistically significant differences in the level of depression by age, gender, educational level achieved and occupation (p < 0.05). There were also statistically significant differences in the level of depression by the number of presenting complaints, the number of chronic diseases, the presence of arthritis, the presence of diabetes mellitus with another chronic disease and the presence of ischaemic heart disease (p < 0.05). No significant differences were found with respect to ethnicity (p = 0.97) or the presence of diabetes mellitus by itself (p = 0.34). Results of logistic regression indicate that the independent predictors of depression (p < 0.05) were the level of education achieved, those with higher levels of education had less depression; the number of presenting complaints, those with more presenting complaints were more likely to be depressed and the presence of arthritis and female gender. It is imperative that policy be developed to address the mental health problems of patients attending these chronic disease clinics. PMID:16642653

  19. Etiological pattern of demented patients attending in a tertiary hospital.

    PubMed

    Islam, M N; Khan, R K; Rahman, M M; Hayee, M A; Jahan, M E; Bhuiya, M M

    2013-07-01

    This is a cross sectional study where 125 demented patients were enrolled who attended in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital. The purpose of the study was to find out the etiology of dementia. Dementia was diagnosed by the criteria indicated by Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and confirmed by Mini Mental State Examination (MMSE) score. Diagnosis of specific type of dementia was made on the basis of established criteria. The most common etiological factor was post stroke dementia (PSDE) (36%) followed by Alzheimer's disease (AD) (14.4%), multi infarct dementia (MID) (8%), Mixed AD and PSDE (6.4%), vitamin B₁₂ deficiency (4.8%) etc. Vascular dementia is the most common etiological factor. Next to this is the Alzheimer disease. This study will provide baseline information regarding the types of dementia occurring in Bangladeshi population and will be the basis of planning health program and data for future research. PMID:23982539

  20. Dispersal, movements and site fidelity of post-fledging King Eiders Somateria spectabilis and their attendant females

    USGS Publications Warehouse

    Bentzen, Rebecca L.; Powell, Abby N.

    2015-01-01

    Post-fledging dispersal and site fidelity are poorly understood, particularly for sea ducks that spend the majority of their annual cycle at sea. This is the first description of movements and their timing for first-year (juvenile) and second-year (subadult) King Eiders Somateria spectabilis in relation to their attendant females. We fitted satellite transmitters that operated for 2 years to 63 hatch-year birds and 17 attendant females at breeding areas in northern Alaska in 2006–2009. Our goals were to describe the spatio-temporal distribution of pre-breeding individuals and adult females that had been successful breeders. We also examined fidelity to wing moulting and wintering areas as well as natal philopatry. Juveniles did not appear to follow attendant adults, although they did winter in the same three general wintering areas, suggesting that genetic inheritance and social factors may have roles in the initial migration from the breeding area. Additionally, juveniles were more variable in the timing and duration of migration, moved longer distances during the winter, and were less faithful to moulting and wintering areas than adults, indicating that individual exploration and acquired navigational memory played a role in subsequent migrations. Most (75%) subadult females returned to natal areas, probably prospecting for future nesting sites, whereas subadult males were widely dispersed at sea. Timing and duration of moult migration and wing moult of adult females that were presumed to be successful breeders differed from those of unsuccessful breeders due to the extended time that the former spent on the breeding grounds. Temporal and spatial segregation of post-fledging King Eiders from adults has direct management implications in terms of resource development and population dynamics.

  1. Psychological Counseling of Female Fertility Preservation Patients.

    PubMed

    Lawson, Angela K; Klock, Susan C; Pavone, Mary Ellen; Hirshfeld-Cytron, Jennifer; Smith, Kristin N; Kazer, Ralph R

    2015-01-01

    Young cancer patients are increasingly interested in preserving their fertility prior to undergoing gonadotoxic therapies. Although the medical safety and treatment protocols for fertility preservation have been well documented, limited research has addressed the emotional issues that arise in fertility preservation patients. We briefly review the literature on the psychosocial issues in adult female fertility preservation treatment and describe our experiences within this patient population. Our findings suggest that several important issues to be addressed during the psychological counseling of adult female fertility preservation patients include: (1) preexisting psychological distress in patients undergoing treatment, (2) choice of fertility preservation strategy in the face of an uncertain relationship future, (3) decision making regarding use of third-party reproduction (e.g., sperm/egg donation, gestational surrogacy), (4) treatment expectations regarding pregnancy and miscarriage, (5) ethical issues related to treatment including the creation, cryopreservation, and disposition of embryos/oocytes, and (6) decision regret from patients who declined fertility preservation. PMID:25996581

  2. [Social support networks for elderly patients attended by Family Health teams].

    PubMed

    Alvarenga, Márcia Regina Martins; Oliveira, Maria Amélia de Campos; Domingues, Marisa Accioly Rodrigues; Amendola, Fernanda; Faccenda, Odival

    2011-05-01

    The aging process has specific aspects marked by the class of individuals and social groups as well as cultural, political, socio-economic and sanitary conditions of the collective groups. Social support systems are essential for meeting the specific needs of the elderly. The aim of this paper is to describe the socio-demographic profile and the social support networks of elderly patients served by the Family Health Strategy. It's a cross-sectional study with elderly patients living in Dourados, in the state of Mato Grosso do Sul (Brazil). Data were collected using a socio-demographic questionnaire and a Minimum Relationships Map for the Elderly (MMRI). Of the 503 elderly patients interviewed, 69% were female, 53.1% were illiterate, 58.3% earned less than one minimum salary and 82.9% lived with others. The MMRI showed that the family was the most important provider of care in all the dimensions assessed, but the elderly have their own small social networks. Elderly patients attended by the Family Health teams have low incomes and little formal education, and social support networks that are too small to meet their needs. PMID:21655734

  3. Multiple Sexual Partnerships among Female Adolescents in Rural Uganda: The effects of family structure and school attendance

    PubMed Central

    Pilgrim, Nanlesta A.; Ahmed, Saifuddin; Gray, Ronald H.; Sekasanvu, Joseph; Lutalo, Tom; Nalugoda, Fred; Serwadda, David; Wawer, Maria J.

    2015-01-01

    Background A better understanding is needed of the contextual factors that influence HIV risk behaviors among female adolescents in sub-Saharan Africa. The objectives of this study were to assess the influence of family structure on lifetime sexual partners and on the number of sexual partners in the last year among female adolescents in rural Rakai, Uganda; and to determine if the influence of family structure on these outcomes differed by adolescents’ school attendance status. Methods The sample consisted of 2,337 unmarried adolescent girls, aged 15-19, enrolled in the Rakai Community Cohort Study. The last survey interview within the time period 2001-2008 available for each girl was used. Analyses were stratified by age (15-17 year olds and 18-19 year olds) and school status. Multinomial logistic regression was used. Results Living in a household with a biological father was protective against both outcomes. Family structure was not associated with the outcomes among in-school adolescents but was significantly associated with outcomes among out-of-school adolescents. Conclusions Findings suggest that understanding the familial context in which female adolescents develop, as well as its interaction with school attendance, is important for HIV prevention efforts. Both research and programmatic initiatives must consider the interplay between the family and school domains when considering ways to reduce HIV acquisition among adolescent women. PMID:25415632

  4. A Pilot Study of Alcohol and Cigarette Consumption among Adolescent and Young Adult Females Attending Health Clinics.

    ERIC Educational Resources Information Center

    Werch, Chudley E.; Dunn, Michael; Woods, Robert

    1997-01-01

    Examines the alcohol and cigarette use patterns of adolescent and young adult female patients (N=246). Results indicate that smoking differences between Whites and Blacks was inversely related to education: less-educated Whites and more-educated Blacks had a greater smoking risk. Conclusions show females' differential needs regarding alcohol and…

  5. Malignant syphilis in an immunocompetent female patient.

    PubMed

    Requena, Camila Bueno; Orasmo, Cínthia Rosane; Ocanha, Juliana Polizel; Barraviera, Silvia Regina Catharino Sartore; Marques, Mariangela Esther Alencar; Marques, Silvio Alencar

    2014-01-01

    Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient. PMID:25387504

  6. Frequency of complementary and alternative medicine utilization in hypertensive patients attending an urban tertiary care centre in Nigeria

    PubMed Central

    Amira, Oluwatoyin C; Okubadejo, Njideka U

    2007-01-01

    Background To study the frequency and pattern of use of complementary and alternative medicine (CAM) in patients with essential hypertension attending a tertiary hypertension clinic. Methods Two hundred and twenty-five consecutive hypertensive patients attending the hypertension clinic of the Lagos University Teaching Hospital over a 3-month period were interviewed. Socio-demographic data, duration of hypertension, clinic attendance, current blood pressure, and compliance to conventional medications was documented. CAM utilization was explored using both structured and open-ended questions. Results There were 90 (40%) male and 135 (60%) female patients with mean age ± SD overall was 55.1 ± 12.4 years. 88 (39.1%) of the respondents used CAM. Herbal products were the most commonly used CAM type. Amongst the CAM users, the most common herbal product used was garlic (69.3%). Others were native herbs (25%), ginger (23.9%), bitter leaf (Vernonia amygdalina) (9.1%), and aloe vera (4.5%). 2.5% used spiritual therapy. There was no difference in the clinical characteristics, socio-economic status, and blood pressure control of CAM users and non-users. Patients who utilized CAM had higher BMI compared with those who did not, but the difference was not statistically significant (mean BMI ± SD of 29.1 ± 5.6 vs 27.1 ± 5.9 kg/m2; P = 0.05). Conclusion A significant proportion of hypertensive patients attending our tertiary facility and receiving conventional treatment also use CAM therapies. Clinicians need to be aware of this practice, understand the rationale for this health-seeking behaviour, proactively enquire about their use, and counsel patients regarding the potential of some of the therapies for adverse reactions and drug interactions. PMID:17903257

  7. Psychological Counseling of Female Fertility Preservation Patients

    PubMed Central

    Lawson, Angela K.; Klock, Susan C.; Pavone, Mary Ellen; Hirshfeld-Cytron, Jennifer; Smith, Kristin N.; Kazer, Ralph R.

    2015-01-01

    Young cancer patients are increasingly interested in preserving their fertility prior to undergoing gonadotoxic therapies. Although the medical safety and treatment protocols for fertility preservation have been well documented, limited research has addressed the emotional issues which arise in fertility preservation patients. We briefly review the literature on the psychosocial issues in adult female fertility preservation treatment and describe our experiences within this patient population patient. Our findings suggest that several important issues to be addressed during the psychological counseling of adult female fertility preservation patients include: 1) pre-existing psychological distress in patients undergoing treatment, 2) choice of fertility preservation strategy in the face of an uncertain relationship future, 3) decision making regarding use of third party reproduction (e.g., sperm/egg donation, gestational surrogacy), 4) treatment expectations regarding pregnancy and miscarriage, 5) ethical issues related to treatment including the creation, cryopreservation, and disposition of embryos/oocytes, and 6) decision regret from patients who declined fertility preservation. PMID:25996581

  8. Buprenorphine Treatment and 12-step Meeting Attendance: Conflicts, Compatibilities, and Patient Outcomes.

    PubMed

    Monico, Laura B; Gryczynski, Jan; Mitchell, Shannon Gwin; Schwartz, Robert P; O'Grady, Kevin E; Jaffe, Jerome H

    2015-10-01

    This analysis examines patient experiences and outcomes with 12-step recovery group attendance during buprenorphine maintenance treatment (BMT), two approaches with traditionally divergent philosophies regarding opioid medications for treatment of opioid use disorder. Using quantitative (n = 300) and qualitative (n = 20) data collected during a randomized trial of counseling services in buprenorphine treatment, this mixed-methods analysis of African Americans in BMT finds the number of NA meetings attended in the prior 6 months was associated with a higher rate of retention in BMT (p < .001) and heroin/cocaine abstinence at 6 month follow-up (p = .005). However, patients whose counselors required them to attend 12-step meetings did not have better outcomes than patients not required to attend such meetings. Qualitative narratives highlighted patients' strategies for managing dissonant viewpoints on BMT and disclosing BMT status in community 12-step meetings. Twelve-step meeting attendance is associated with better outcomes for BMT patients over the first 6 months of treatment. However, there is no benefit to requiring meeting attendance as a condition of treatment, and clinicians should be aware of potential philosophical conflicts between 12-step and BMT approaches. PMID:25986647

  9. Gender and Higher Education in Different National Spaces: Female Palestinian Students Attending Israeli and Jordanian Universities

    ERIC Educational Resources Information Center

    Abu-Rabia-Queder, Sarab; Arar, Khaled

    2011-01-01

    This study examines the higher education experience among Palestinian Arab females in two national spaces and seeks to determine whether studying at an Arab institution of higher learning in a nearby Arab country can alleviate the emotional and economic difficulties that affect Palestinian women at Israeli universities. What can institutions of…

  10. Cystosarcoma phylloides in adolescent female patients.

    PubMed

    Briggs, R M; Walters, M; Rosenthal, D

    1983-12-01

    Nine cases of cystosarcoma phylloides in adolescent female patients are reported along with an additional 35 cases collected from the literature. Analysis of these 44 cases revealed 37 (84.1 percent) benign lesions, 6 (13.6 percent) malignant tumors, and 1 borderline lesion. Excision was the most common operative procedure and was performed in 35 patients. Nine patients underwent mastectomy. There were three recurrent lesions (one benign and two malignant) for a recurrence rate of 6.8 percent. Wide excision was successful in the treatment of recurrent lesions. On the basis of these data, excision is the preferred initial therapy of cystosarcoma phylloides in the adolescent patient regardless of the histologic classification of the lesion. Malignant cystosarcoma is more likely to recur than a benign lesion but a recurrence can be managed with reexcision. Sacrifice of the adolescent breast at the initial procedure is strongly discouraged. PMID:6316797

  11. Prevalence and Pattern of Pain Presentation among Patients Attending a Tertiary Dental Center in a Southern Region of Nigeria

    PubMed Central

    Gbenga Omitola, Olufemi; Olabisi Arigbede, Abiodun

    2010-01-01

    Background and aims Orofacial pain is one of the most common reasons for attendance at the dental clinic. The prevalence and the sources of orofacial pain vary from place to place and patients’ response to pain also differs. The aim of this study was to determine the prevalence and pattern of orofacial pain as well as the factors influencing patients’ response to orofacial pain among patients presenting for dental treatment in our center. Materials and methods Consecutive patients presenting with orofacial pain at the Dental Center, University of Port Harcourt Teaching Hospital during the one-year period of the study were recruited into the study. Patients’ demographic data were collected and recorded in special forms. Patients were later examined to confirm the specific cause of pain. This was also recorded. Data generated were analyzed using SPSS for Windows. Results Four hundred and forty-eight patients out of the 2,426 patients seen during the study period had orofacial pain, yielding a prevalence rate of 18.5%. There were 255 females and 193 males with most patients in the 17-27-year age group (49.1%). Lower jaw was commonly affected. Most patients presented after a period of at least one month, with severe and spontaneous pain. Most patients had drug therapy before presentation. Caries was the most common source of orofacial pain. Conclusion Orofacial pain was not uncommon in our center and it accounted for about 20% of patients’ attendance in the center. Dental caries and periodontal diseases were the most common sources of orofacial pain while temporomandibu-lar joint pain and atypical facial pain were not common in our center. Young adults and females were most commonly affected. PMID:22991595

  12. Denture care practice among patients attending the prosthetic clinic in a Nigerian teaching hospital

    PubMed Central

    Ogunrinde, Tunde Joshua; Opeodu, Olanrewaju Ige

    2015-01-01

    Background: Good denture care practice by individuals using Removable Partial Denture (RPD) is an important component of oral health measures. An assessment of denture care practice of such individuals by dental care practitioners is necessary. Objective: To evaluate the denture care practice among prosthetics patients attending a tertiary Hospital Dental Centre in Nigeria. Materials and Methods: An interviewer administered questionnaire was used to obtain information from RPD wearers that were willing to participate. The questionnaire assessed among other things, patients’ bio-data, frequency, techniques and device used for cleaning their dentures. Data was analyzed using Chi-square test (P < 0.05). Results: One hundred and ninety eight denture wearers consisting of 100 (50.5%) males and 98 (49.5%) females participated in the study. Majority 110 (55.6%) cleaned their dentures once daily and toothbrush and pastes were used by 105 (53%) of the participants. More than 70% of the respondents removed their dentures at night. One hundred and sixty-six (83.8%) visited the dentist only when they needed treatment. There was a statistical significant relationship between frequency and technique of cleaning denture, and denture cleanliness (P < 0.05). Conclusion: This study shows that once daily cleaning of dentures and cleaning the denture with rest of the teeth are ineffective in prevention of plaque accumulation. PMID:26229229

  13. Fertility preservation in female cancer patients.

    PubMed

    Kim, Chung-Hoon; Jeon, Gyun-Ho

    2012-01-01

    With improved survival rates among cancer patients, fertility preservation is now being recognized as an issue of great importance. There are currently several methods of fertility preservation available in female cancer patients and the options and techniques via assisted reproduction and cryopreservation are increasing, but some are still experimental and continues to be evaluated. The established means of preserving fertility include embryo cryopreservation, gonadal shielding during radiation therapy, ovarian transposition, conservative gynecologic surgery such as radical trachelectomy, donor embryos/oocytes, gestational surrogacy, and adoption. The experimental methods include oocyte cryopreservation, ovarian cryopreservation and transplantation, in vitro maturation, and ovarian suppression. With advances in methods for the preservation of fertility, providing information about risk of infertility and possible options of fertility preservation to all young patients with cancer, and discussing future fertility with them should be also considered as one of the important parts of consultation at the time of cancer diagnosis. PMID:22462006

  14. Cervical cancer knowledge and screening behaviors among female university graduates of year 2012 attending national graduate orientation program, Bhutan

    PubMed Central

    2014-01-01

    Background Cervical cancer is the leading female cancer in Bhutan. This study describes the level of cervical cancer knowledge and screening behaviors among female university graduates attending the National Graduate Orientation Program (NGOP), 2012. Methods A cross-sectional study of female graduates attending NGOP was conducted using self-administered anonymous questionnaire developed through literature reviews and expert discussions to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. The association of demographic and other important study characteristics with uptake of Pap test was investigated using cross tabulation and Fischer Exact test. Frequencies and percentages were calculated for all the questions. Results The average age of the participants was 23.43 ± SD 2.73. About 92% (n = 513) of the respondents were aged 25 years or less and 7.9% (n = 44) of the respondents were aged 26 or more. The study revealed low cervical cancer knowledge and poor screening behavior among the graduates. The mean knowledge score was 3.571 (SD1.75, Range 0–8). About 6% (n=34) of the respondents reported undergoing Pap test at least once and 94% reported as never having done Pap test. The most commonly cited reasons for not doing Pap test included “never thought I needed one” (57%, n = 320), “embarrassment of being examined by male health professional” and “fear of finding out cancer”. The study revealed evidence of significant association between increasing age, those who are married, knowledge score and those recommended for screening by health professionals with the uptake of Pap test. Conclusion Our study revealed poor knowledge and screening behaviors among female university graduates in Bhutan. This may be suggestive of even poorer awareness and screening practices among young unmarried women who are less educated or with no education. Although our study group is not

  15. Carolinas HealthCare attends to patients, amenities; builds business.

    PubMed

    Rees, T

    2000-01-01

    Carolinas HealthCare System has grown into a nearly two billion dollar entity by focusing on patient needs and amenities in its health care facilities. Growth of the system, the largest in North and South Carolina, is due in large part to Harry A. Nurkin, president and CEO, who started out with a run-down hospital for indigents. With the approval of the hospital board, Nurkin launched a marketing effort that included taking a lesson from the founders of the Holiday Inn hotel chain. He remodeled and developed facilities that are pleasing to patients and visitors, moved patient parking closer to the hospitals' front doors, taught key hospital personnel the basics about marketing, aligned the system with ABA and NFL teams and conducted an aggressive advertising program. PMID:11143133

  16. An Investigation into Patient Non-Attendance and Use of a Short-Message Reminder System at a University Dental Clinic.

    PubMed

    Storrs, Mark J; Ramov, Helen M; Lalloo, Ratilal

    2016-01-01

    Non-attended appointments in health care facilities create inefficiencies and loss of clinical productivity: clinical teaching hours are reduced, impacting students' ability to meet the competencies necessary for professional registration. The aim of this study was to assess demographic and time-related factors for patient non-attendance at a dental school clinic in Australia. Appointment data were extracted from the patient management system for the years 2011 and 2012. Data included the status of appointment (attended, cancelled, or failed to attend [FTA]) and an array of demographic and time-related factors. Multinomial logistic regression was conducted to assess relationships between these factors and appointment status. Attendance rates were also compared by year following implementation of a short message service (SMS) reminder at the beginning of 2012. The results showed that, of 58,622 appointments booked with students during 2011 and 2012, 68% of patients attended, 23% cancelled, and 9% were FTA. The percentage of non-attended (cancelled or FTA) appointments differed by demographic and time-related factors. Females were 7% less likely to be FTA, those aged 16-24 years were five times more likely to be FTA, and early morning appointments were 18% less likely to be cancelled and FTA. With the SMS reminder system, the odds of a cancellation were 15% higher, but FTAs were 14% lower (both were statistically significant differences). This study found that failing to attend an appointment was significantly related to a number of factors. Clinical scheduling and reminder systems may need to take these factors into account to decrease the number of teaching hours lost due to patients' missing their appointments. PMID:26729682

  17. Cervical intraepithelial lesions in females attending Women's Health Clinics in Alexandria, Egypt

    PubMed Central

    Abdel-Hadi, Mona; Khalaf, Adel; Aboulkassem, Hanaa; Naeem, Noha; Baqy, Mohamed Abdel; Sallam, Hassan

    2015-01-01

    Background: Data from Egyptian studies provide widely varying estimates on the prevalence of preinvasive cervical lesions. The aim of this study was to estimate the rate of cervical intraepithelial neoplasia (CIN) in Egyptian women living in Alexandria to clarify the need for implementing a national organized screening program and a vaccination program in our community. Materials and Methods: The study was conducted over a 6 years period and covered the different socioeconomic levels to have a representative sample for women living in Alexandria. All women included did not have any cervical disorder related complaints. Conventional Pap smears were obtained and diagnosed using the Bethesda system. Women with abnormal Pap smears were managed according to the 2006 consensus guidelines within the available facilities. Persistent abnormal cytological results were referred for colposcopic biopsy. Histological results were grouped into: Reactive changes, CIN 1, CIN 2/CIN 3 and adenocarcinoma in-situ (AIS). Results: Out of the 6173 smears included in the study 6072 (98.36%) were normal and only 101 (1.63%) were abnormal. After colposcopic biopsies, 0.08% had CIN 1, 0.03% had CIN 2, 3 and 0.01% had AIS. Conclusion: We concluded that cervical cancer screening programs, although life-saving for a number of women, are not a sufficiently high priority in our community. Money for national health screening programs should preferably be directed more towards recruiting women for breast cancer screening, since breast cancer accounts for about 33% of all female cancers in Egypt ranking number one, while cervical cancer ranks number 13. PMID:26195985

  18. Etiological beliefs of patients with neurological disorders attending a tertiary care center: A cross-sectional study

    PubMed Central

    Bajaj, Bhupender Kumar; Chaudhary, Shipra; Shrestha, Runa

    2013-01-01

    Background: The understanding and management of neurological disorders is undergoing revolutionary changes over the last three decades in the background of ever increasing advances in medical technologies, diagnostic techniques, therapeutic processes and, molecular and genetic medicine. The fruits of these advances can reach patients only if the psychosocial hurdles in their delivery are identified, acknowledged and addressed. Aim: To explore the beliefs and practices of patients with neurological disorders in a tertiary care center in the eastern Nepal. Materials and Methods: One hundred patients attending neurology/medicine outpatient for neurological disorders were interviewed about their beliefs regarding the triggering factors, causation and treatment-seeking behavior particularly from traditional healers. Result: Of the 100 patients (49 males, 51 females) recruited in the study, 51% expressed having ‘no idea’ about their illness. Only 20% patients gave medically congruent explanation for their illness. Psychological factors were attributed as triggering factors by 16% of patients, of which two-thirds were females. Chance, destiny and ‘jadu tona’ topped the list of triggering factors. Forty-four percent patients had sought help of traditional faith healers (‘Dhami Jhakri’) before seeking medical help. Traditional faith healers were approached by patients irrespective of their educational background. Fifty-nine percent of patients who first sought traditional faith healers, believed in ‘jadu-tona’. Of those interviewed, 16% were planning to go to a faith healer in near future. Conclusion: The beliefs of patients with neurological disorders frequently do not conform to current medical opinion. There is need for greater communication and education of patients by their treating physicians. PMID:24347941

  19. Acoustic Noise Levels of Dental Equipments and Its Association with Fear and Annoyance Levels among Patients Attending Different Dental Clinic Setups in Jaipur, India

    PubMed Central

    Ganta, Shravani; Nagaraj, Anup; Pareek, Sonia; Atri, Mansi; Singh, Kushpal; Sidiq, Mohsin

    2014-01-01

    Background: Noise is a source of pervasive occupational hazard for practicing dentists and the patients. The sources of dental sounds by various dental equipments can pose as a potential hazard to hearing system and add to the annoyance levels of the patients. The aim of the study was to analyze the noise levels from various equipments and evaluate the effect of acoustic noise stimulus on dental fear and annoyance levels among patients attending different dental clinic setups in Jaipur, India. Methodology: The sampling frame comprised of 180 patients, which included 90 patients attending 10 different private clinics and 90 patients attending a Dental College in Jaipur. The levels of Acoustic Noise Stimulus originating from different equipments were determined using a precision sound level meter/decibulometer. Dental fear among patients was measured using Dental Fear Scale (DFS). Results: Statistical analysis was performed using chi square test and unpaired t-test. The mean background noise levels were found to be maximum in the pre-clinical setup/ laboratory areas (69.23+2.20). Females and the patients attending dental college setup encountered more fear on seeing the drill as compared to the patients attending private clinics (p<0.001). Conclusion: The sources of dental sounds can pose as a potential hazard to hearing system. It was analyzed that the environment in the clinics can directly have an effect on the fear and annoyance levels of patients. Hence it is necessary control the noise from various dental equipments to reduce the fear of patients from visiting a dental clinic. PMID:24959512

  20. Fertility preservation in female classic galactosemia patients.

    PubMed

    van Erven, Britt; Gubbels, Cynthia S; van Golde, Ron J; Dunselman, Gerard A; Derhaag, Josien G; de Wert, Guido; Geraedts, Joep P; Bosch, Annet M; Treacy, Eileen P; Welt, Corrine K; Berry, Gerard T; Rubio-Gozalbo, M Estela

    2013-01-01

    Almost every female classic galactosemia patient develops primary ovarian insufficiency (POI) as a diet-independent complication of the disease. This is a major concern for patients and their parents, and physicians are often asked about possible options to preserve fertility. Unfortunately, there are no recommendations on fertility preservation in this group. The unique pathophysiology of classic galactosemia with a severely reduced follicle pool at an early age requires an adjusted approach. In this article recommendations for physicians based on current knowledge concerning galactosemia and fertility preservation are made. Fertility preservation is only likely to be successful in very young prepubertal patients. In this group, cryopreservation of ovarian tissue is currently the only available technique. However, this technique is not ready for clinical application, it is considered experimental and reduces the ovarian reserve. Fertility preservation at an early age also raises ethical questions that should be taken into account. In addition, spontaneous conception despite POI is well described in classic galactosemia. The uncertainty surrounding fertility preservation and the significant chance of spontaneous pregnancy warrant counseling towards conservative application of these techniques. We propose that fertility preservation should only be offered with appropriate institutional research ethics approval to classic galactosemia girls at a young prepubertal age. PMID:23866841

  1. Fertility preservation in female classic galactosemia patients

    PubMed Central

    2013-01-01

    Almost every female classic galactosemia patient develops primary ovarian insufficiency (POI) as a diet-independent complication of the disease. This is a major concern for patients and their parents, and physicians are often asked about possible options to preserve fertility. Unfortunately, there are no recommendations on fertility preservation in this group. The unique pathophysiology of classic galactosemia with a severely reduced follicle pool at an early age requires an adjusted approach. In this article recommendations for physicians based on current knowledge concerning galactosemia and fertility preservation are made. Fertility preservation is only likely to be successful in very young prepubertal patients. In this group, cryopreservation of ovarian tissue is currently the only available technique. However, this technique is not ready for clinical application, it is considered experimental and reduces the ovarian reserve. Fertility preservation at an early age also raises ethical questions that should be taken into account. In addition, spontaneous conception despite POI is well described in classic galactosemia. The uncertainty surrounding fertility preservation and the significant chance of spontaneous pregnancy warrant counseling towards conservative application of these techniques. We propose that fertility preservation should only be offered with appropriate institutional research ethics approval to classic galactosemia girls at a young prepubertal age. PMID:23866841

  2. Long-term attendance at a family practice teaching unit. Qualitative study of patients' views.

    PubMed Central

    Brown, J. B.; Dickie, I.; Brown, L.; Biehn, J.

    1997-01-01

    OBJECTIVE: To identify the factors that contribute to patients' long-term attendance at a family practice teaching unit. DESIGN: Qualitative method of focus groups. SETTING: A community-based family practice teaching unit in southwestern Ontario. PARTICIPANTS: Patients who had been coming to St Joseph's Family Medical Centre for more than 15 years were purposefully selected to participate. METHOD: Five focus groups composed of patients who had been affiliated with one of the three practices at the Centre for more than 15 years explored factors contributing to long-term attendance. MAIN FINDINGS: Four key themes were identified as the primary factors contributing to long-term attendance: the relationship context, the team concept, professional responsibility and attitudes, and comprehensive and convenient care. CONCLUSION: The resource-rich era of medical care, during which participants formulated their views and opinions about the factors contributing to their long-term attendance at a family practice teaching unit, has come to a close. The findings of this study provide important information that could help maintain one of the basic tenets of family medicine-continuity of care. PMID:9154362

  3. Likelihood of Attending Treatment for Anxiety Among Veteran Primary Care Patients: Patient Preferences for Treatment Attributes.

    PubMed

    Shepardson, Robyn L; Funderburk, Jennifer S

    2016-09-01

    Anxiety is common, but under-treated, in primary care. Behavioral health providers embedded in primary care can help address this treatment gap. Guidance on anxiety treatment preferences would help inform tailoring of clinical practice and new interventions to be more patient-centered and increase treatment engagement. We surveyed 144 non-treatment seeking Veteran primary care patients (82.6 % male, 85.4 % White, age M = 59.8 years, SD = 13.9) reporting current anxiety symptoms (M = 13.87, SD = 3.66, on the Generalized Anxiety Disorder-7 Questionnaire) on their likelihood of attending anxiety treatment featuring various levels of 11 attributes (modality, type, location, format, provider, visit frequency, visit length, treatment duration, type of psychotherapy, symptom focus, and topic/skill). Participants indicated clear preferences for individual, face-to-face treatment in primary care, occurring once a month for at least 30 min and lasting at least three sessions. They also tended to prefer a stress management approach focused on trouble sleeping or fatigue, but all topics/skills were rated equivalently. For most attributes, the highest rated options were consistent with characteristics of integrated care. Implications for research and practice are discussed. PMID:27465641

  4. How patient-centered do female physicians need to be? Analogue patients' satisfaction with male and female physicians' identical behaviors.

    PubMed

    Hall, Judith A; Roter, Debra L; Blanch-Hartigan, Danielle; Mast, Marianne Schmid; Pitegoff, Curtis A

    2015-01-01

    Previous research suggests that female physicians may not receive appropriate credit in patients' eyes for their patient-centered skills compared to their male counterparts. An experiment was conducted to determine whether a performance of higher (versus lower) verbal patient-centeredness would result in a greater difference in analogue patient satisfaction for male than female physicians. Two male and two female actors portrayed physicians speaking to a patient using high or low patient-centered scripts while not varying their nonverbal cues. One hundred ninety-two students served as analogue patients by assuming the patient role while watching one of the videos and rating their satisfaction and other evaluative responses to the physician. Greater verbal patient-centeredness had a stronger positive effect on satisfaction and evaluations for male than for female physicians. This pattern is consistent with the hypothesis that the different associations between patient-centeredness and patients' satisfaction for male versus female physicians occur because of the overlap between stereotypical female behavior and behaviors that comprise patient-centered medical care. If this is the case, high verbal patient-centered behavior by female physicians is not recognized as a marker of clinical competence, as it is for male physicians, but is rather seen as expected female behavior. PMID:25175277

  5. Oral mucosal lesions in skin diseased patients attending a dermatologic clinic: a cross-sectional study in Sudan

    PubMed Central

    2011-01-01

    Background So far there have been no studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML) in patients with dermatologic diseases. This is noteworthy as skin lesions are strongly associated with oral lesions and could easily be neglected by dentists. This study aimed to estimate the frequency and socio-behavioural correlates of OML in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. Methods A cross-sectional hospital-based study was conducted in Khartoum from October 2008 to January 2009. A total of 588 patients (mean age 37.2 ± 16 years, 50.3% females) completed an oral examination and a personal interview of which 544 patients (mean age 37.1 ± 15.9 years, 50% females) with confirmed skin disease diagnosis were included for further analyses. OML were recorded using the World Health Organization criteria (WHO). Biopsy and smear were used as adjuvant techniques for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1). Cross tabulation and Chi-square with Fisher's exact test were used. Results A total of 438 OML were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p < 0.05) skin diseased patients. Thus, a certain number of patients had more than one type of OML. Tongue lesions were the most frequently diagnosed OML (23.3%), followed in descending order by white lesions (19.1%), red and blue lesions (11%) and vesiculobullous diseases (6%). OML in various skin diseases were; vesiculobullous reaction pattern (72.2%), lichenoid reaction pattern (60.5%), infectious lesions (56.5%), psoriasiform reaction pattern (56.7%), and spongiotic reaction pattern (46.8%). Presence of OML in skin diseased patients was most frequent in older age groups (62.4% older versus 52.7% younger, p < 0.05), in males (63.2% males versus 52.6% females, p < 0.05), patients with a systemic disease (65.2% with systemic versus 51.9% without

  6. Effect of attending to a ball during a side-cut maneuver on lower extremity biomechanics in male and female athletes.

    PubMed

    Fedie, Rebecca; Carlstedt, Kristen; Willson, John D; Kernozek, Thomas W

    2010-09-01

    Many sports associated with anterior cruciate ligament (ACL) injury require athletes attend to a ball during participation. We investigated effects of attending to a ball on lower extremity mechanics during a side-cut maneuver and if these effects are consistent for males and females. Sagittal and frontal plane hip and knee kinematics and joint moments were measured during side-cut maneuvers in 19 male and 19 female National Collegiate Athletic Association division III basketball players. Participants also experienced two side-cut conditions that required attention to a ball. Our results did not indicate that the effect of attention varies with gender. However, during side-cut conditions while attending to a ball, internal knee adductor moment was 20% greater (p = 0.03) and peak knee flexion angle was 4 degrees larger (p < 0.01). Females demonstrated 5 degrees less hip flexion (p = 0.046), 12 degrees less knee flexion (p < 0.01), and 4 degrees more knee abduction (p = 0.026) at initial contact during all side-cut conditions than males. Attention to a ball may affect lower extremity mechanics relevant to ACL injury. The validity of laboratory studies of lower extremity mechanics for sports that include attention to a ball may be increased if participants are required to attend to a ball during the task. PMID:21162362

  7. Choroidoretinal granuloma in a young female patient

    PubMed Central

    Massa, Horace F; Gatzioufas, Zisis; Mangioris, Georgios; Panos, Georgios D

    2014-01-01

    A 16-year-old Brazilian female patient presented with blurring of vision in the right eye. Corrected visual acuity was OD 2/20, OS 20/20. Afferent pupillary defect was absent and anterior segment examination revealed anterior uveitis. Fundus examination showed light vitritis and a raised grey–white granuloma located at posterior pole with focal serous retinal detachment on optical coherence. Indocyacnine green angiography disclosed a complete mask effect in granuloma's area. Differential diagnoses were infectious (bacterial, viral, fungal and parasites) diseases, systemic inflammatory diseases, tumours. Blood serologies (HIV, toxoplasma, Borrelia, cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), rubeola) showed positive results for IgM and IgG for toxoplasma, and anterior chamber tap (PCR for toxoplasma, CMV, HSV, VZV) revealed toxoplasma DNA. Anti-toxoplasma therapy, pyrimethamine, sulfadiazine and calcium folinate, was administered immediately. On follow-up granuloma regression was observed, with complete visual restoration. This case demonstrates a clinically challenging posterior pole granuloma. PMID:24744062

  8. Choroidoretinal granuloma in a young female patient.

    PubMed

    Massa, Horace F; Gatzioufas, Zisis; Mangioris, Georgios; Panos, Georgios D

    2014-01-01

    A 16-year-old Brazilian female patient presented with blurring of vision in the right eye. Corrected visual acuity was OD 2/20, OS 20/20. Afferent pupillary defect was absent and anterior segment examination revealed anterior uveitis. Fundus examination showed light vitritis and a raised grey-white granuloma located at posterior pole with focal serous retinal detachment on optical coherence. Indocyacnine green angiography disclosed a complete mask effect in granuloma's area. Differential diagnoses were infectious (bacterial, viral, fungal and parasites) diseases, systemic inflammatory diseases, tumours. Blood serologies (HIV, toxoplasma, Borrelia, cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), rubeola) showed positive results for IgM and IgG for toxoplasma, and anterior chamber tap (PCR for toxoplasma, CMV, HSV, VZV) revealed toxoplasma DNA. Anti-toxoplasma therapy, pyrimethamine, sulfadiazine and calcium folinate, was administered immediately. On follow-up granuloma regression was observed, with complete visual restoration. This case demonstrates a clinically challenging posterior pole granuloma. PMID:24744062

  9. Correlates for cardiovascular diseases among diabetic/hypertensive patients attending outreach clinics in two Nairobi slums, Kenya

    PubMed Central

    Mugure, Gladys; Karama, Mohamed; Kyobutungi, Catherine; Karanja, Simon

    2014-01-01

    Introduction Cardiovascular diseases (CVD) are the leading cause of death in the world. Over 80% of CVD related deaths occur in low- and middle-income countries (LMICs). Diabetes and hypertension, whose prevalence in Kenya is on the rise, are major risk factors for CVD. Despite this, studies indicate that awareness on the management of risk factors for CVD among diabetic/hypertensive patients in African populations is generally low. The aim of the study was to determine the risk factors for CVD among diabetic and/or hypertensive patients attending diabetes and hypertension management clinics in Korogocho and Viwandani slums of Nairobi. Methods Data were collected using questionnaires administered to 206 diabetic/hypertensive patients attending the clinics between July 2010 and February 2011. A review of these patients’ medical records was done to determine the history of CVD outcomes such as hypertensive heart diseases, stroke and peripheral arterial diseases. Results Majority (66.5%) of the study participants were females mainly in the 51-65 age category. The study findings revealed that 73 (33.4%) respondents had CVD outcomes. In addition, 41.8% of the respondents were not aware of the causes of diabetes/hypertension. Age category 51-65 years had the highest (43.8%) number of respondents with CVD. Sex of the respondents and awareness of the link between hypertension and CVD were significantly associated with CVD outcomes (p<0.05) among the respondents. Conclusion Measures to improve awareness levels among patients at high risk of CVD outcomes are needed to complement other measures to reduce CVD risk among such patients. PMID:25852804

  10. Health literacy screening of patients attending a student-led osteopathy clinic: A pilot investigation.

    PubMed

    Vaughan, Brett; Mulcahy, Jane; Fitzgerald, Kylie

    2016-08-01

    Adequate levels of health literacy (HL) are required for patients to access appropriate health services and develop an understanding of the options for managing their healthcare needs. There is limited literature on HL of patients seeking care for a musculoskeletal complaint. The present study sought to screen the HL of patients presenting to an Australian osteopathy student-led clinic using a single screening question 'Are you confident completing medical forms?'. Less than 10% of patients attending the clinic were considered to have below adequate levels of HL using this question, consistent with other work in Australian populations. Logistic regression analysis identified that the most significant demographic variables associated with lower HL were patients who did not speak English at home, those with lower education levels, and those who were less satisfied with their life. Evaluation of a patients' HL may assist practitioners to improve patient education and management strategies. PMID:27502799

  11. Irritable Bowel Syndrome and Female Patients.

    PubMed

    Harris, Lucinda A; Umar, Sarah B; Baffy, Noemi; Heitkemper, Margaret M

    2016-06-01

    Irritable bowel syndrome is probably the most common functional gastrointestinal disorder and is characterized by abdominal pain along with altered bowel function. It is a disorder of female predominance. This article focuses on how being female influences the pathophysiology, diagnosis, management, and treatment of this common disorder and discusses the evidence and important controversies related to these areas. PMID:27261893

  12. Study on Glycaemic Status and Lipid Profile in Type 2 Diabetic Patients Attending Mymensingh Medical College Hospital, Mymensingh.

    PubMed

    Tabazzum, R; Mia, A R; Haq, R U; Epsi, E Z

    2016-07-01

    Recent increases in the incidence of diabetes in developing countries have been associated with complications resulting in mortality and morbidity. A case control study of 120 subjects attending out patient department of Mymensingh Medical College, Mymensingh was done with an aim to evaluate alteration of serum lipid profile and HbA1c in type 2 diabetic patients and compare with age matched healthy control. Of the total cases, 60 were Type 2 diabetic patients and 60 were apparently healthy persons recruited for the study. These patients and control subjects were classified as male (50%) and female (50%). Fasting lipid profile and HbA1c% were measured by following the standard laboratory methods. The study subjects had relatively poor glycemic control. The mean HbA1c was 9.21±1.19% in diabetes patient and 4.71±0.60% was in control. The mean fasting blood glucose level was 10.18±1.56mmol/L in diabetes patient and 4.51±0.48mmol/L in control. The mean total cholesterol, triacylglycerols, HDL-C & LDL-C were 211.93±11.83mg/dl, 156.90±7.96mg/dl, 35.20±3.17mg/dl & 133.20±3.99mg/dl in diabetes patient accordingly and the mean total cholesterol, triacylglycerols, HDL-C & LDL-C were 159.72±4.89mg/dl, 117.45±12.97mg/dl, 44.23±2.75mg/dl & 92.15±5.67mg/dl in control group accordingly. The study revealed that the most common abnormality seen was decreased serum HDL-Cholesterol levels (91.67%). Hypertriglyceridaemia present in 81.67% patients, 78.34% had high LDL-Cholesterol and 73.34% had hypercholesteromia. Diabetic males had significantly higher levels of total cholesterol and LDL-Cholesterol compared to diabetic females and diabetic females had significantly lower levels of HDL-Cholesterol compared to diabetic males. It was concluded from the results of this study that, diabetic patients are more prone to develop dyslipidaemia. Thus early diagnosis of dyslipidemia and good glycaemic control can be used as a preventive measure for the development of cardiovascular

  13. Capsaicin cough sensitivity is related to the older female predominant feature in chronic cough patients

    PubMed Central

    Song, Woo-Jung; Kim, Ju-Young; Jo, Eun-Jung; Lee, Seung-Eun; Kim, Min-Hye; Yang, Min-Suk; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Min, Kyung-Up

    2014-01-01

    Purpose The present study aimed to examine the age and gender distributions among chronic cough patients referred to a tertiary cough clinic in Korea, and to investigate clinical factors related to the demographic findings. Methods Study participants were unselectively recruited from adult chronic cough patients who attended the cough clinic for the first time during one year. To validate their representativeness, their age and gender distributions were compared to the entire chronic cough population, or with those presenting with other chronic disease. Data from the baseline investigations were analyzed to identify clinical factors related to the demographic findings. Results A total of 272 chronic cough patients were included. They had a middle-aged female predominant feature (mean age: 52.8±15.7 years and female 69.1%). Their age and gender distributions were almost identical to the entire chronic cough population, but were distinct from patients with hypertension. Among clinical factors, the older female predominance was associated with enhanced capsaicin cough sensitivity, and also with the presence of 'cough by cold air' symptom. Allotussia and laryngeal paresthesia were highly common in chronic cough patients, affecting 94.8% and 86.8% of them, respectively. Conclusions The present study demonstrated older female predominance among adult chronic cough patients attending a referral cough clinic in Korea. The demographic features were significantly associated with the capsaicin cough responses and also potentially with allotussia (particularly cold air as the trigger). These findings suggest a role of cough reflex sensitization in the pathophysiology of chronic cough in adults. PMID:25228996

  14. Efficacy of urgent thoracotomy for trauma in patients attended by a helicopter emergency medical service.

    PubMed

    Purkiss, S F; Williams, M; Cross, F W; Graham, T R; Wood, A

    1994-10-01

    Over a 12-month period the Helicopter Emergency Medical Service underwent 1084 missions attending casualties in the London area. Sixteen patients required an emergency thoracotomy for resuscitation, nine of which were performed at the scene and seven in the emergency department. The median injury severity score of these patients was 29.9 (SIR 11.8) of which 11 had suffered blunt injuries. Medical attention at scene was administered 16.2 min (SIR 4.0) following the London ambulance service receiving the emergency call. Significantly longer time was spent attending patients who had a scene thoracotomy (35.1 min SIR 16.4) compared with those in whom the thoracotomy was performed in the casualty department. No patient in this series survived resuscitative thoracotomy. It is suggested that scene thoracotomy be abandoned and emphasis placed upon the rapid transport of patients to an emergency facility. This enables other resuscitative measures in addition to thoracotomy to be applied effectively and concentrated over a brief period by a multidisciplinary team. PMID:7861336

  15. Use of the Internet by patients attending hospital for oral and maxillofacial procedures.

    PubMed

    Shafi, A; Dewar, A; Cowan, C; Sood, V; Brennan, P A; Hislop, S

    2014-01-01

    Information obtained on the Internet regarding medical procedures is largely unregulated and can be confusing. The aims of this study were to assess use of the Internet by patients attending hospital for oral and maxillofacial procedures, and to assess the quality of information provided at consultation. Data were collected prospectively using a confidential questionnaire, which was distributed to consecutive patients attending for elective operations at 2 oral and maxillofacial units: Crosshouse Hospital, Kilmarnock, and Queen Alexandra Hospital, Portsmouth (n=100 at each unit). All the distributed questionnaires were returned. At both units, 95% of patients thought that discussion at the initial consultation was good or very good, and 84% at both units stated that they had access to the Internet. Internet access was consistently high among all age groups up to the age of 65, but in those aged over 65 it was considerably lower. A total of 22/84 patients (26%) at Crosshouse, and 14/84 (17%) at Queen Alexandra used the Internet to gain further information regarding their condition or procedure. All of those (n=14) at Queen Alexandra, and 21/22 at Crosshouse had used Google to search for the information. Those who used the Internet to find information on their medical condition or procedure found it to be a useful resource, but they also stated that the information caused some concerns. With use of the Internet and access to it increasing we highlight the need for regulated and appropriate websites to which patients should be directed. PMID:23891264

  16. Evaluating awareness regarding oral hygiene practices and exploring gender differences among patients attending for oral prophylaxis

    PubMed Central

    Oberoi, Sukhvinder Singh; Mohanty, Vikrant; Mahajan, Ananya; Oberoi, Avneet

    2014-01-01

    Background: Oral hygiene is intimated in health of all parts of the body including oral cavity. The understanding of actual practices in keeping the oral heath at standard based on patient's perceptions of oral health care is vital. Understanding the effect of gender on oral health would facilitate the development of successful attitude and behavior modification approach towards sustainable oral health. Purpose of Study: To evaluate awareness regarding oral hygiene practices and exploring gender differences among patients attending for oral prophylaxis. Materials and Methods: A survey was conducted among 250 patients attending the department of periodontology, Maulana Azad institute of dental sciences for oral prophylaxis. A structured questionnaire was used to collect information regarding practices and perception about oral hygiene. Results: Majority of the patients (60.4%) felt that oral hygiene is mandatory for overall health of the body. The use of toothpaste and toothbrush (83.6%) was the most preferred cleaning aid among the study population in the present study. The major constraint for avoiding dental examination was no felt need (41.2%) followed by cost of dental treatment (26.8%) and time constraints (24.0%). Conclusions: Professional plaque removal and regular follow-up combined with oral hygiene instructions to the patients can minimize the level of gingival inflammation and swelling. The poor resources for dental care, common malpractices and nonavailability of professional care are the main barriers in seeking optimum oral hygiene. PMID:25024553

  17. Sexual Concerns of Male Spouses of Female Alzheimer's Disease Patients.

    ERIC Educational Resources Information Center

    Litz, Brett T.; And Others

    1990-01-01

    Presents case study which highlights attendant cognitive changes that occur in Alzheimer's patient, presenting caregiver with challenges to couple's sexual functioning. Describes man who reported erectile dysfunction directly stemming from stressful changes that had occurred in his relationship to his wife who had Alzheimer's disease. General…

  18. Medicinal herb use among asthmatic patients attending a specialty care facility in Trinidad

    PubMed Central

    Clement, Yuri N; Williams, Arlene F; Aranda, Derick; Chase, Ronald; Watson, Nadya; Mohammed, Rochelle; Stubbs, Odia; Williamson, Deneil

    2005-01-01

    Background There is an increasing prevalence of asthma in the Caribbean and patients remain non-compliant to therapy despite the development of guidelines for management and prevention. Some patients may self-medicate with medicinal herbs for symptomatic relief, as there is a long tradition of use for a variety of ailments. The study assessed the prevalence of use and the factors affecting the decision to use herbs in asthmatic patients attending a public specialty care clinic in Trinidad. Methods A descriptive, cross-sectional study was conducted at the Chest Clinic in Trinidad using a de novo, pilot-tested, researcher-administered questionnaire between June and July 2003. Results Fifty-eight out of 191 patients (30.4%) reported using herbal remedies for symptomatic relief. Gender, age, ethnicity, and asthma severity did not influence the decision to use herbs; however, 62.5% of patients with tertiary level schooling used herbs, p = 0.025. Thirty-four of these 58 patients (58.6%) obtained herbs from their backyards or the supermarket; only 14 patients (24.1%) obtained herbs from an herbalist, herbal shop or pharmacy. Relatives and friends were the sole source of information for most patients (70.7%), and only 10.3% consulted an herbalist. Ginger, garlic, aloes, shandileer, wild onion, pepper and black sage were the most commonly used herbs. Conclusions Among patients attending the Chest Clinic in Trinidad the use of herbal remedies in asthma is relatively common on the advice of relatives and friends. It is therefore becoming imperative for healthcare providers to become more knowledgeable on this modality and to keep abreast with the latest developments. PMID:15713232

  19. Hyponatremia and in-hospital mortality in patients admitted for heart failure (from the ATTEND registry).

    PubMed

    Sato, Naoki; Gheorghiade, Mihai; Kajimoto, Katsuya; Munakata, Ryo; Minami, Yuichiro; Mizuno, Masayuki; Aokage, Toshiyuki; Asai, Kuniya; Sakata, Yasushi; Yumino, Dai; Mizuno, Kyoichi; Takano, Teruo

    2013-04-01

    Hyponatremia is known to be a poor prognostic factor in patients hospitalized with heart failure (HF), however not well studied in Japan. The aims of this study were to characterize hyponatremic hospitalized patients with HF and to clarify the relations between hyponatremia and detailed in-hospital outcomes in Japan. Among 4,837 hospitalized patients with HF enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, patient characteristics and in-hospital mortality in those with hyponatremia were examined. Hyponatremia (sodium <135 mEq/L) was observed in 11.6% of patients. Patients with hyponatremia were of similar age, included fewer men, and had a higher proportion of previous hospitalizations for HF compared to those with normonatremia. On admission, lower heart rates and blood pressures and higher brain natriuretic peptide levels were observed in patients with hyponatremia. During hospitalization, inotrope levels and mechanical device use were significantly higher in patients with hyponatremia. Rates of all-cause and cardiac death were significantly higher in patients with hyponatremia, 15.0% and 11.4%, respectively, compared to 5.3% and 3.6%, respectively, in those with normonatremia. In hyponatremic hospitalized patients with HF, cardiac death accounted for 76.2% of all-cause death. In conclusion, the present study demonstrates that in Japan hyponatremia in patients hospitalized with HF is relatively common and is associated with a very high in-hospital mortality. PMID:23312128

  20. Factors affecting disability in patients attending the internal medicine departments of general hospitals.

    PubMed

    Sata, M; Yoshitake, K; Utsunomiya, H; Hatada, K; Ohtsuka, T; Sugasaki, H; Nakane, Y

    1999-12-01

    The aim of this study was to investigate the effect of sociodemographic factors, physical factors and mental factors on the physical and social disability of patients attending outpatient clinics of general hospitals. Physical and psychiatric morbidity in 1580 consecutive patients attending the internal medicine department of general hospitals was assessed using a stratified two-stage sampling design method. Of the total, 336 patients completed the second stage interview composed of Primary Care Version of Composite International Diagnostic Interview and Groningen Social Disability Schedule to assess sociodemographic, physical and mental factors. In this study, restricted activity days, disability days and Brief Disability Questionnaire were used for the assessment of physical disability, and Groningen Social Disability Schedule was used for social disability. Sociodemographic, physical and mental factors were all related to disability. Among sociodemographic factors, unemployment was associated with physical disability and social disability mildly. Among physical factors, the severity of physical disease was not associated with disability and medically explained somatic symptoms were associated with disability. Furthermore, the mental factor was more strongly associated with physical and social disability. It could be said that the mental factor is more strongly associated with physical and social disability than sociodemographic or physical factors. In addition, even mild mental symptoms not leading to ICD-10 mental disorders affected disability. From the viewpoint of the patients' burden, it is important to assess the mental symptoms as well as physical status in outpatient clinics of internal medicine or primary care. PMID:10687740

  1. Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

    PubMed Central

    Birhanu, Anteneh Messele; Alemu, Fekadu Mazengia; Ashenafie, Tesfaye Demeke; Balcha, Shitaye Alemu; Dachew, Berihun Assefa

    2016-01-01

    Background Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI): 11.7–19.2). Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0) and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92) were the factors associated with depression among diabetic patients. Conclusion The prevalence of depression was low as compared to other similar studies elsewhere. Disease (diabetes) duration of 10 years and above and being a Muslim religion follower (as compared to Christian) were the factors significantly associated with depression. Early screening of depression and treating depression as a routine component of diabetes care are recommended. Further research with a large sample size, wider geographical coverage, and segregation of type of diabetes mellitus is recommended. PMID:27274296

  2. Pattern of Dermatophytes in Patients Attend in Mymensingh Medical College Hospital.

    PubMed

    Monwar, S; Hossain, M A; Mahmud, M C; Paul, S K; Nasreen, S A; Joly, S N; Begum, H; Abdullah, S A; Haque, N; Sarkar, S R

    2015-10-01

    Dermatophytosis is a common fungal disease which involves the keratinized tissue. This is an attempt to observe the spectrum of dermatophytes among the clinically suspected cases of dermatophytosis attending the outpatient department of Dermatology and Venereology, Mymensingh Medical College Hospital, Mymensingh during the period of July 2013 to December 2014. Two hundred thirty (230) clinically suspected cases of dermatophytosis were subjected in this study. Sixty three cases (27.39%) were positive for fungus in direct microscopy while 53(23.04%) were culture positive. Among the clinical types tinea unguium was the most common followed by tinea corporis. Dermatophytosis was more common in the age group of 21-30 years. The male to female ratio was 1.53:1. Trichophyton rubrum 44(83.04%) was found common etiological dermatophyte species followed by Trichophyton mentagrophytes 5(9.43%) and Epidermophyton floccosum 4(7.55%). PMID:26620004

  3. Attendance patterns of California sea lion (Zalophus californianus) females and pups during the non-breeding season at San Miguel Island

    USGS Publications Warehouse

    Melin, S.R.; DeLong, R.L.; Thomason, J.R.; VanBlaricom, G.R.

    2000-01-01

    The attendance patterns of California sea lions were studied during the non-breeding seasons from 1991 to 1994. Lactating females frequented the rookery to nurse their pups until weaning; most non-lactating females left the rookery for the season. Females spent over 70% of their time at sea except in 1993 when they spent 59% of their time at sea. The mean foraging trip length in the winter and spring ranged from 3.3 to 4.6 d; the mean nursing visit ranged from 1.2 to 1.4 d. The duration of foraging trips and nursing visits was variable over the season for individuals but no pattern of change was detected. Interannual and seasonal differences were not significant for time at sea, visits ashore, or foraging-trip duration before, during, or after the 1992-1993 El Nino event. Pups spent an average of 66.6% of their time ashore and up to three days away from the rookery during their mother's absence. Most females and pups stayed associated until April or May. The results suggest that seasonal movement of prey is more important in determining attendance patterns late in the lactation period than increasing energy demands of the pup.

  4. Does organizational culture affect out-patient DNA (did not attend) rates?

    PubMed

    Jackson, S

    1997-01-01

    Government interest in health service "did not attend" (DNA) rates was seen to occur by accident, following which efforts to reduce DNAs have tended to concentrate on operational rather than strategic issues. Considers the effect hospital culture has had on DNA rates from an organizational and patient perspective. Identifies some of the key cultural issues that impacted on DNA rates by utilizing observation and telephone survey research methods. Concludes that, in the main, the lack of customer-oriented organizational culture was seen to affect DNA rates adversely within one NHS provider trust. PMID:10179096

  5. Prevalence of Traumatic Dental Injuries in Patients Attending University of Alberta Emergency Clinic

    PubMed Central

    Alkhadra, Thamer; Preshing, William; El-Bialy, Tarek

    2016-01-01

    Objectives: This study evaluated the prevalence of dental trauma for patients attending the emergency dental clinic at the University of Alberta Hospital between 2006-2009. Patients’ examination and treatment charts were reviewed. Methods: Total number of patients’ charts was 1893.The prevalence of different types of trauma was 6.4 % of the total cases (117 patients). Trauma cases were identified according to Ellis classification and as modified by Holland et al., 1988. Results: Logistic statistical model showed that 21.7% were Ellis class I trauma, 16.7% were Ellis class II trauma, and 6.7% were Ellis class III. In addition, 11.7 % presented with avulsion, 7.5 % presented with dentoalveolar fracture and 7.5% presented with sublaxation. Also, 17.55 % presented with tooth displacement within the alveolar bone, 3.3 % presented with crown fracture with no pulp involvement, 4.16 % presented with crown fracture with pulp involvement and 3.3 % presented with root fracture. In conclusion, the general prevalence of dentoalveolar trauma in patients attending the emergency clinic at the University of Alberta is less than other reported percentages in Canada or other countries. PMID:27398104

  6. A comparison of quality and satisfaction experiences of patients attending chiropractic and physician offices in Ontario

    PubMed Central

    Crowther, Edward R.

    2014-01-01

    Introduction: Improving the quality of healthcare is a common goal of consumers, providers, payer groups, and governments. There is evidence that patient satisfaction influences the perceptions of the quality of care received. Methods: This exploratory, qualitative study described and analyzed, the similarities and differences in satisfaction and dissatisfaction experiences of patients attending physicians (social justice) and chiropractors (market justice) for healthcare services in Niagara Region, Ontario. Using inductive content analysis the satisfaction and dissatisfaction experiences were themed to develop groups, categories, and sub-categories of quality judgments of care experiences. Results: Study participants experienced both satisfying and dissatisfying critical incidents in the areas of standards of practice, professional and practice attributes, time management, and treatment outcomes. Cost was not a marked source of satisfaction or dissatisfaction. Conclusion: Patients may be more capable of generating quality judgments on the technical aspects of medical and chiropractic care, particularly treatment outcomes and standards of practice, than previously thought. PMID:24587494

  7. Urethral cavernous hemangioma in a female patient: a rare entity

    PubMed Central

    Bolat, Mustafa Suat; Yüzüncü, Kubilay; Akdeniz, Ekrem; Demirdoven, Ayse Nurten

    2015-01-01

    Genitourinary hemangiomas are rare entities of the urinary system. We reported a female patient who suffered dyspareunia and intermitant hematuria that was proved as urethral cavernous hemangioma. Despite its benign nature, hemangiomas may recur due to incomplet excision. PMID:26985270

  8. The importance of empathy in the enablement of patients attending the Glasgow Homoeopathic Hospital.

    PubMed Central

    Mercer, Stewart W; Reilly, David; Watt, Graham C M

    2002-01-01

    BACKGROUND: Patient enablement in general practice is known to be limited by consultation length. However, the processes within the consultation that lead to enablement are not well understood. AIMS: To investigate patient enablement in a setting where time is less of a constraint than in primary care, in order to determine the importance of other factors in enablement. DESIGN OF STUDY: Exploratory questionnaire-based study. SETTING: Two hundred consecutive outpatients attending four doctors at the Glasgow Homoeopathic Hospital, an NHS-funded integrated complementary and orthodox medicine unit. METHOD: Information was collected on enablement and a range of other factors, including the patients expectations, their perception of the doctors empathy, and the doctors own confidence in the doctor-patient relationship. RESULTS: Although there were many factors that correlated with enablement, multi-regression analysis showed patients expectation, doctor's empathy (as perceived by the patient), and doctor's own confidence in the therapeutic relationship to be the three key factors. Together they accounted for 41% of the variation in enablement, with empathy being the single most important factor (66% of the explained variation in enablement). CONCLUSION: Patient enablement at the Glasgow Homoeopathic Hospital is mainly related to the patients perception of the doctor's empathy. PMID:12434958

  9. Breaking the Taboo: An Exploration of Female University Students' Experiences of Attending a Feminist-Informed Sex Education Course

    ERIC Educational Resources Information Center

    Askew, Julie

    2007-01-01

    This article presents the results of a qualitative interview study of nine young women who attended a feminist-informed human sexuality course as undergraduate students at a US university located in the "Bible belt". The course focused on messages of desire and empowerment, rather than romance or fear, and was designed to encourage students to…

  10. Predictive score for mortality in patients with COPD exacerbations attending hospital emergency departments

    PubMed Central

    2014-01-01

    Background Limited information is available about predictors of short-term outcomes in patients with exacerbation of chronic obstructive pulmonary disease (eCOPD) attending an emergency department (ED). Such information could help stratify these patients and guide medical decision-making. The aim of this study was to develop a clinical prediction rule for short-term mortality during hospital admission or within a week after the index ED visit. Methods This was a prospective cohort study of patients with eCOPD attending the EDs of 16 participating hospitals. Recruitment started in June 2008 and ended in September 2010. Information on possible predictor variables was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up. Main short-term outcomes were death during hospital admission or within 1 week of discharge to home from the ED, as well as at death within 1 month of the index ED visit. Multivariate logistic regression models were developed in a derivation sample and validated in a validation sample. The score was compared with other published prediction rules for patients with stable COPD. Results In total, 2,487 patients were included in the study. Predictors of death during hospital admission, or within 1 week of discharge to home from the ED were patient age, baseline dyspnea, previous need for long-term home oxygen therapy or non-invasive mechanical ventilation, altered mental status, and use of inspiratory accessory muscles or paradoxical breathing upon ED arrival (area under the curve (AUC) = 0.85). Addition of arterial blood gas parameters (oxygen and carbon dioxide partial pressures (PO2 and PCO2)) and pH) did not improve the model. The same variables were predictors of death at 1 month (AUC = 0.85). Compared with other commonly used tools for predicting the severity of COPD in stable patients, our rule was significantly better

  11. High frequency of low serum levels of vitamin 12 among patients attending Jordan University Hospital.

    PubMed

    Barghouti, F F; Younes, N A; Halaseh, L J; Said, T T; Ghraiz, S M

    2009-01-01

    This study aimed to estimate the status of serum vitamin B12 level in patients attending Jordan University Hospital in Amman, and to examine the relationship with demographic data, chronic illness, dietary habits, haematological parameters and symptoms related to vitamin B12 levels. A total of 838 patients completed a questionnaire and gave blood samples; 44.6% were vitamin B12 deficient (< 180 pg/mL) and 34.2% had hypovitaminosis (180-300 pg/mL). Vitamin B12 deficiency was associated with memory impairment, low meat intake and strict vegetarian (vegan) diets. The high frequency of low vitamin B12 warrants the development of a strategy to correct this problem in Jordan. PMID:20187536

  12. Prevalence of Chronic Kidney Disease among Patients Attending a Specialist Diabetes Clinic in Jamaica

    PubMed Central

    Ferguson, TS; Tulloch-Reid, MK; Younger-Coleman, NO; Wright-Pascoe, RA; Boyne, MS; Soyibo, AK; Wilks, RJ

    2015-01-01

    ABSTRACT Objectives: To estimate the prevalence of chronic kidney disease (CKD) among patients attending the University Hospital of the West Indies (UHWI) Diabetes Clinic and to determine the proportion of patients at high risk for adverse outcomes. Methods: We conducted a cross-sectional study among patients attending the UHWI Diabetes Clinic between 2009 and 2010. Trained nurses administered a questionnaire, reviewed dockets, and performed urinalyses. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Albuminuria was assessed using urine test strips for protein and microalbumin. Chronic kidney disease was defined as an eGFR < 60 ml/min/1.73m2 or albuminuria ≥ 30 mg/g creatinine. Risk of adverse outcome (all-cause mortality, cardiovascular disease and kidney failure) was determined using the Kidney Disease: Improving Global Outcome (KDIGO) 2012 prognosis grid. Results: Participants included 100 women and 32 men (mean age, 55.4 ± 12.9 years, mean duration of diabetes, 16.7 ± 11.7 years). Twenty-two per cent of participants had eGFR < 60 ml/min/1.73m2. Moderate albuminuria (30–300 mg/g) was present in 20.5% of participants and severe albuminuria (> 300 mg/g) in 62.1%. Overall prevalence of CKD was 86.3% (95% CI 80.4%, 92.2%). Based on KDIGO risk categories, 50.8% were at high risk and 17.4% at very high risk of adverse outcomes. Conclusion: Most patients at the UHWI Diabetes Clinic had CKD and were at high or very high risk of adverse outcomes. Further studies to determine the burden of CKD in other clinical settings and to identify the best strategies for preventing adverse outcomes in developing countries need to be conducted. PMID:26426170

  13. Prevalence of HIV-Associated Neurocognitive Disorder (HAND) among Patients Attending a Tertiary Health Facility in Northern Nigeria

    PubMed Central

    Yusuf, Abdulkareem Jika; Hassan, Abdulaziz; Mamman, Aisha Indo; Muktar, Haruna Mohammed; Sulieman, Aishatu Maude; Baiyewu, Olusegun

    2014-01-01

    Background HIV-associated neurocognitive disorder (HAND) is a great source of morbidity in sub-Saharan African region. However, the magnitude of this problem remains largely uninvestigated despite having the largest number of population with HIV/AIDS. The aim of this study is to determine the prevalence of HAND among patients attending a tertiary health facility in Nigeria. Method We conducted a cross-sectional study among HIV-positive patients on antiretroviral therapy (ART) for at least 1 year. They were assessed using the International HIV Dementia Scale, Word Recall Test, Stick Design Test, Subjective Cognitive Complaint Questionnaire, Alcohol Use Disorder Identification Test, Drug Abuse Screening Test, Center for Epidemiological Study–Depression Scale, Instrumental Activity of Daily Living, and neurological examination. The CD4 count and viral load were determined for all the participants. A consensus diagnosis was made on each case based on the Frascati criteria. Data obtained were analyzed using “SPSS” for Windows version 15. Results A total of 418 HIV-positive patients participated in the study, of which 325 (77.8%) are females. The mean age (standard deviation) of the participants was 37.2 (9.3) years. The prevalence of HAND was 21.5% (95% confidence interval [CI] = 17.6%-25.4%), of which 9.6% were asymptomatic. The significant predictors of HAND in this study are duration of illness (odds ratio [OR] = 1.33 P < .001), detectable viral load (OR = 0.19, P < .001), CD4 count (OR = 0.99, P < .001), education (OR = 0.94, P = .011), stopping medication (OR = 3.55 P = .01), and severity of illness (OR = 1.24, P = .005). Conclusion One-fifth of the HIV-positive patients in this study had HAND. Various sociodemographic and clinical features were related to the prevalence of HAND. PMID:25331222

  14. Quality of nursing care and satisfaction of patients attended at a teaching hospital1

    PubMed Central

    de Freitas, Juliana Santana; Silva, Ana Elisa Bauer de Camargo; Minamisava, Ruth; Bezerra, Ana Lúcia Queiroz; de Sousa, Maiana Regina Gomes

    2014-01-01

    Objectives assess the quality of nursing care, the patients' satisfaction and the correlation between both. Method cross-sectional study, involving 275 patients hospitalized at a teaching hospital in the Central-West of Brazil. The data were collected through the simultaneous application of three instruments. Next, they were included in an electronic database and analyzed in function of the positivity, median value and Spearman's correlation coefficients. Results among the nursing care assessed, only two were considered safe - hygiene and physical comfort; nutrition and hydration - while the remainder were classified as poor. Nevertheless, the patients were satisfied with the care received in the domains assessed: technical-professional, confidence and educational. This can be justified by the weak to moderate correlation that was observed among these variables. Conclusion Despite the quality deficit, the patients' satisfaction level with the nursing care received was high. These results indicate that the institution needs to center its objectives on a continuing evaluation system of the care quality, aiming to attend to the patients' expectations. PMID:25029057

  15. Detecting psychological distress among patients attending secondary health care clinics. Self-report and physician rating.

    PubMed

    Feldman, D; Rabinowitz, J; Ben Yehuda, Y

    1995-11-01

    A study was conducted to determine the prevalence of psychological distress, as reported by patients and their physicians, in orthopedic, neurology, dermatology, and ophthalmology clinics; to study their accuracy in detecting psychological distress; and to determine if there is any connection among psychological distress, accuracy of detecting distress, and use of mental health and primary health care physicians' prognosis for the somatic complaints. Five hundred and fifty-six patients, ages 18-21, responded to the Psychiatric Epidemiology Research Interview Demoralization Scale (PERI-D), a measure of psychological distress, and to questions about their mental health and use of mental health and primary health services. Physicians, who were blind to patients' responses, were asked to what extent they thought the cause of patients' complaints was physical and to what extent they thought it was psychological in nature, and to prognosticate. Based on the PERI-D, about 25% of patients were distressed, this was less for females than males and varied between clinics. Based on self-reporting, about 14% of patients (males and females) were distressed. Based on physician reporting, about 17% (males less) were distressed. Physicians identified 35% of the PERI-D-distressed cases and 79% of nondistressed cases. About 66% of patients identified their distress and 83% their lack of distress. Increased use of primary health care and mental health care was related to distress. The prognosis was negatively related to distress. Based on this study, there is a need for more attention to psychological distress among secondary health care patients. Patients' ability to identify their distress suggests the importance of involving the patient in the diagnostic process. Correct detection of distress alone does not appear to decrease the use of primary medical and mental health services. PMID:8714802

  16. Psychiatric Disorders in Children and Adolescents Attending Pediatric Out Patient Departments of Tertiary Hospitals

    PubMed Central

    Jesmin, Akhter; Rahman, Khan Muhammad Zillur; Muntasir, Maruf Mohammad

    2016-01-01

    Objectives Psychiatric disorders are increasingly recognized among children and adolescents in Bangladesh. Psychiatric disorders are more common in children with chronic and acute pediatric disorders. Our study was designed to determine the psychiatric disorders among children and adolescents attending pediatric outpatient departments of tertiary care hospitals. Methods This cross-sectional study was carried out from July 2012 to February 2013 in pediatric outpatient departments of three prime tertiary level hospitals of Dhaka, Bangladesh. A purposive sampling technique was used. A total of 240 male and female children aged 5 to 16 years old were included in the study. We used a semi-structured questionnaire to obtain sociodemographic and other relevant clinical information about the children and their families from their parents or caregivers and a validated parent version of the Bangla Development and Well-Being Assessment (DAWBA) for measuring psychopathology. Results The mean age of the children was 9.0± 2.6 years. The majority (71%) of children were in the 5–10 year age group. The male/female ratio was 1.2:1. Among the respondents, 18% were found to have a psychiatric disorder. Behavioral disorders, emotional disorders, and developmental disorders were found in 9.0%, 15.0% and 0.4% respectively. Hyperkinetic disorder was the single most frequent (5.0%) psychiatric disorder. Conclusions A significant number of children were found to have psychiatric disorders. Our study indicates the importance of identification and subsequent management of psychiatric conditions among the pediatric population. PMID:27403237

  17. Ethnocultural and sex characteristics of patients attending a tertiary care pain clinic in Toronto, Ontario

    PubMed Central

    Mailis-Gagnon, Angela; Yegneswaran, Balaji; Nicholson, Keith; Lakha, SF; Papagapiou, Marios; Steiman, Amanda J; Ng, Danny; Cohodarevic, Tea; Umana, Margarita; Zurowski, Mateusz

    2007-01-01

    BACKGROUND: Ethnocultural factors and sex may greatly affect pain perception and expression. Emerging literature is also documenting racial and ethnic differences in pain access and care. OBJECTIVE: To define the sex and ethnocultural characteristics of patients attending a tertiary care, university-affiliated pain clinic in Toronto, Ontario. METHODS: Data were collected on 1242 consecutive, new patients seen over a three-year period at the Comprehensive Pain Program (CPP) in downtown Toronto. Data were compared with the Canada 2001 Census. RESULTS: English-speaking, Canadian-born patients constituted 58.6% of the CPP population, similar to the 2001 Canadian Census data for the Greater Toronto Area. Certain visible minority groups (Indo-Pakistani and Chinese) were significantly under-represented, while European groups were over-represented. While women outnumbered men, they presented with lower levels of physical pathology in general, particularly in certain ethnic groups. Patients from Europe (representing primarily immigrants who arrived in Canada before 1960), were older, by 10 years to 15 years, than the average CPP population, and had a much higher incidence of physical or medical disorders. CONCLUSIONS: The implications of the study and the importance of sex and ethnicity in terms of presentation to Canadian pain clinics are discussed. Future well-designed studies are needed to shed light on the role of both patients’ and physicians’ ethnicity and sex in pain perception and expression, decision-making regarding pain treatments and acceptance of pain treatments. PMID:17505571

  18. Efficacy of insulin analogues in diabetic patients attending primary care centers

    PubMed Central

    Bardisi, Wedad M.; Khorsheed, Manal M.; Magliah, Faisal; Magliah, Ayman F.

    2015-01-01

    Objectives: To measure the efficacy of new insulin analogues compared with the conventional types of insulin, and to compare their effects on patient satisfaction regarding their weight changes and the frequency of hypoglycemic episodes. Methods: In this retrospective cohort observational study, data was collected from the medical records of 122 eligible diabetics on insulin therapy attending government primary care centers in Jeddah, Kingdom of Saudi Arabia from June 2013 to July 2014. The data collected considered the efficacy, safety, and patient satisfaction of the types of insulin therapy used for their treatment. Results: After 12 weeks, there was a reduction in mean glycosylated hemoglobin (HbA1c) of -0.88% for the analogue type versus -0.19% for the conventional type, and at 24 weeks, the mean drop in HbA1c was -2.02% for the analogue type versus -1.12% for the conventional type, but the differences were not statistically significant. More patients (87% versus 38%) on analogue compared with conventional insulin treatment were satisfied with therapy. Conclusion: In the primary health care setting, insulin analogues showed greater efficacy improvements than conventional insulin therapy within 6 months. However, conventional insulin therapy can still be used at primary care centers with limited resources, and when patients refuse to be converted. PMID:26108587

  19. Revision Stapedectomy in a Female Patient with Inner Ear Malformation

    PubMed Central

    Patel, Tirth R.; Moberly, Aaron C.

    2016-01-01

    Objectives. We describe an unusual case of surgical management of congenital mixed hearing loss in a female patient with inner ear malformation. This report outlines the role of temporal bone imaging and previous surgical history in evaluating a patient's risk of perilymph gusher during stapes surgery. Methods. A 68-year-old female patient with a history of profound bilateral mixed hearing loss due to ossicular and cochlear malformation presented to our otology clinic. She had undergone multiple unsuccessful previous ear surgeries. Computed tomography revealed bilateral inner ear malformations. She elected to proceed with revision stapedectomy. Results. The patient received modest benefit to hearing, and no operative complications occurred. Conclusions. Although stapedectomy has been shown to improve hearing in patients with stapes fixation, there is risk of perilymph gusher in patients with inner ear abnormalities. Evaluation and counseling of the risk of gusher during stapes surgery should be done on a case-by-case basis. PMID:27144044

  20. Prevalence of xerostomia in patients attending Shorish dental speciality in Sulaimani city

    PubMed Central

    2015-01-01

    Objectives: The aim of this study was to investigate the prevalence of xerostomia among dental patients and explore the possible risk factors and symptoms associated with this condition. Patient and Methods: The prevalence of xerostomia and its associations were investigated among patients (n=1132) who were visiting the department of oral medicine at shorish dental speciality in sulaimani city. The age range was between 10-79 years. 512 (45.2%) of participants were males and 620 (54.8%) were females. The data collected were age, sex, systemic diseases, medications and habit of smoking. Logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association of xerostomia with age, systemic diseases and medications and Chi Square test was also used to analyze the data. Results: Prevalence of xerostomia was 16.07%. Prevalence of xerostomia was significantly higher among females (19.51%) than males (11.91%) (P=0.001). The most common diseases with the highest prevalence of xerostomia were psychological disorders (57.14%) followed by diabetes mellitus (53.84%), neurological disorders (40%), thyroid disorders (37.5%) and hypertension (36.48%). The most common medication with the highest prevalence of xerostomia was antihistamine (66.66%) followed by psychotherapeutic medications (60%), pain medications (55.88%), endocrinologic agents (51.21%), antidyslipidic agents (50%) and antihypertensive medication (38.98%). Xerostomia was significantly associated with ageing (OR: 1.02, P=0.000), systemic diseases (OR: 2.80, P=0.000) and medications (OR: 5.17, P=0.000). There was a high prevalence of reported symptoms of xerostomia and these symptoms were more prevalent among females, Prevalence of xerostomia was higher in heavy smoker patients (19.48%) than non smoker patients but not significantly (16.14%) (p= 0.44). Conclusions: There was a high prevalence of xerostomia among dental patients; xerostomia was significantly more

  1. Prevalence of excessive or problem drinkers among patients attending somatic outpatient clinics: a study of alcohol related medical care.

    PubMed Central

    Persson, J; Magnusson, P H

    1987-01-01

    The prevalence of alcohol related morbidity was studied among 2038 patients attending somatic outpatient clinics. A further 76 patients had refused the study, giving an overall drop out rate of 3.6%. Several methods were combined so as to detect as many patients with problem drinking as possible. According to the criteria and definitions employed 17% of men (confidence interval 15% to 19%) and 4% of women (confidence interval 3% to 5%) were excessive consumers of alcohol or problem drinkers. The highest proportion of such patients--that is, 17%--was noted in the emergency rooms (27% of men, 8% of women). At other clinics the proportions varied from 11% to 17% of men and from 2% to 4% of women. The strongest relations between overconsumption of alcohol and consultation at the clinic were among patients attending the medical outpatient clinic and the emergency rooms; in 86% (confidence interval 75% to 97%) and 88% (confidence interval 81% to 95%) of problem drinkers attending these clinics, respectively, alcohol was related to the consultation. Consultations were related to alcohol in 82% of women with excessive or problem drinking and 73% of men defined in this way. There was a tendency to a higher proportion of men with excessive or problem drinking in the age group 40-49 years. These findings show that among patients classified as excessive or problem drinkers attending somatic outpatient clinics there was a close relation between alcohol consumption and utilisation of medical resources, especially in women. PMID:3117173

  2. Lessons from patients with hemoptysis attending a chest clinic in India

    PubMed Central

    Prasad, Rajendra; Garg, Rajiv; Singhal, Sanjay; Srivastava, Piyush

    2009-01-01

    OBJECTIVE: To evaluate the various etiologies of hemoptysis. MATERIALS AND METHODS: Four hundred and seventy-six consecutive patients of hemoptysis who were admitted to the Department of Pulmonary Medicine between January 1996 and December 2002 were included in this study. Hemoptysis was categorized as mild (< 100 ml/day), moderate (100–400 ml/day), and massive (>400 ml/day). We also categorized the patients according to the primary etiology of the hemoptysis. RESULTS: Of the 476 patients with hemoptysis included in this study, 352 were males and 124 were females. Pulmonary tuberculosis was the leading cause of hemoptysis. There were 377 (79.2%) patients in the pulmonary tuberculosis group, 25 (5.7%) in the neoplasm group, 19 (4.0%) in the chronic bronchitis group, 18 (3.8%) in the bronchiectasis group, and 35 (7.3%) patients with hemoptysis due to other causes. About one-third of the patients with hemoptysis had been misdiagnosed by the referring doctor as having active pulmonary tuberculosis. CONCLUSION: Although pulmonary tuberculosis is the most important cause of hemoptysis in India, it may also occur due to a variety of other causes. Awareness should be increased among general physicians about the various etiologies of hemoptysis in pulmonary tuberculosis patients. PMID:19561915

  3. Awareness about prescribed drugs among patients attending Out-patient departments

    PubMed Central

    Singh, Jaswinder; Singh, Narinder; Kumar, Rahat; Bhandari, Vikram; Kaur, Navpreet; Dureja, Sheveta

    2013-01-01

    Background: Communication skills play an important role in establishing doctor-patient relationship is widely recognized throughout the world. The information passed on to the patients affects the treatment outcomes. Objectives: The present study was undertaken to evaluate the level of awareness among OPD patients about prescribed drugs. Materials and Methods: A total of two hundred sixty four patients having a valid prescription from a doctor practicing in allopathic system, visiting 4 different chemist shops in a North Indian city were enrolled in the study. All the enrolled patients were given a preformed questionnaire to be answered on the spot. Results: It was found that though a considerable number of patients were aware about the therapeutic effects of the drugs and the manner of administration of the medicines; they lacked information regarding the side effects, warnings and the information their doctor may require at the next consultation. Conclusion: The study highlighted the fact that doctors need to spend more time with the patients to make them active participants in the drug therapy. PMID:23776839

  4. Medication Adherence, Work Performance and Self-Esteem among Psychiatric Patients Attending Psychosocial Rehabilitation Services at Bangalore, India

    PubMed Central

    Gandhi, Sailaxmi; Pavalur, Rajitha; Thanapal, Sivakumar; Parathasarathy, Nirmala B.; Desai, Geetha; Bhola, Poornima; Philip, Mariamma; Chaturvedi, Santosh K.

    2014-01-01

    Context: Work benefits mental health in innumerable ways. Vocational rehabilitation can enhance self-esteem. Medication adherence can improve work performance and thereby the individuals’ self-esteem. Aim: To test the hypothesis that there would be a significant correlation between medication adherence, work performance and self-esteem. Setting and Design: A quantitative, descriptive correlational research design was adopted to invite patients attending psychiatric rehabilitation services to participate in the research. Material and Methods: Data was collected from a convenience sample of 60 subjects using the ‘Medication Adherence Rating scale’, ‘Griffiths work behaviour scale’ and the ‘Rosenberg's Self-esteem scale’. Statistical analysis used: Analysis was done using spss18 with descriptive statistics, Pearsons correlation coefficient and multiple regression analysis. Results: There were 36 males and 24 females who participated in this study. The subjects had good mean medication adherence of 8.4 ± 1.5 with median of 9.00, high mean self-esteem of 17.65 ± 2.97 with median of 18.0 and good mean work performance of 88.62 ± 22.56 with median of 93.0. Although weak and not significant, there was a positive correlation (r = 0.22, P = 0.103) between medication adherence and work performance; positive correlation between (r = 0.25, P = 0.067) medication adherence and self–esteem; positive correlation between (r = 0.136, P = 0.299) work performance and self-esteem. Multiple regression analysis showed no significant predictors for medication adherence, work performance and self-esteem among patients with psychiatric illness. Conclusions: Medication monitoring and strengthening of work habit can improve self-esteem thereby, strengthening hope of recovery from illness. PMID:25336771

  5. Perceptions of burden of caregiving by informal caregivers of cancer patients attending University of Calabar Teaching Hospital, Calabar, Nigeria

    PubMed Central

    Akpan-Idiok, Paulina Ackley; Anarado, Agnes Nonye

    2014-01-01

    Introduction Cancer care is devastating to families. This research studied the informal caregivers’ perceptions of burden of caregiving to cancer patients attending University of Calabar Teaching Hospital, Calabar. Methods The research adopted a cross-sectioned descriptive design and 210 caregivers providing care to advanced cancer patients were purposively selected. Data were collected using a researcher developed questionnaire and standardized Zarit Burden Interview scale (ZBIS). Data collected were analysed using descriptive and chi-square statistics with the help of SPSS 18.0 and PAS 19.0 softwares. Results The results indicated that the caregivers were in their youthful and active economic age, dominated by females, Christians, spouses, partners and parents. The burden levels experienced by the caregivers were as follows: severe (46.2%), moderate (36.2%) and trivial of no burden (17.6%). The forms of burden experienced were physical (43.4%), psychological (43.3%), financial (41.1%) and social (46.7%), quite frequently and nearly always. Psychological and social forms of burden had the highest weighted score of 228 in terms of magnitude of burden. The result further showed that there was a significant (P = 0.001) and inverse association between caregivers’ burden and the care receivers’ functional ability. The level of burden also increased significantly (P = 0.000) with the duration of care, while there was also a significant (P = 0.01) relationship between caregivers’ experience of burden and their desire to continue caregiving. Conclusion Caregiving role can be enhanced by provision of interventions such as formal education programme on cancer caregiving, oncology, home services along side with transmural care. PMID:25419297

  6. Clinical manifestations of neuromyelitis optica in male and female patients.

    PubMed

    Yin, Jianrui; Long, Youming; Shan, Fulan; Fan, Yongxiang; Wu, Linzhan; Zhong, Rong; Gao, Cong; Chen, Xiaohui; Gao, Qingchun; Yang, Ning

    2015-11-01

    Neuromyelitis optica (NMO) is a severe, idiopathic, immuno-mediated, inflammatory demyelinating disease of the central nervous system. We examined the clinical features between male and female NMO patients, for which not much data exist. One hundred and eight Chinese Han patients with NMO were analysed retrospectively, all had been detected for the aquaporin-4 (AQP4) antibody using a cell-based assay. Of 108 NMO patients, 92 were female and 16 were male (female/male = 5.75). Ninety-four (87%) were positive for the AQP4 antibody in their serum and/or cerebral spinal fluid. Aquaporin-4 antibody-positive NMO patients had a higher female/male ratio than the negative group (P = 0.001). Female NMO patients had a higher positive rate of the AQP4 antibody than male NMO patients (92.4 vs 56.3%, P = 0.001). All NMO male patients were divided according to their AQP4 antibody status. 77.8% (7/9) of patients in the seropositive group had initial optic neuritis, while only one patient (14.3%, 1/7) in the negative group had optic neuritis (P = 0.041). Limb paraesthesia was reported in only one patient in the negative group (11.1%), but it was reported in all patients in the positive group (100%) (P = 0.001). The mean length of vertebral segments of the spinal cord lesions was 3.6 ± 1.3 in the positive group, while it was 6.6 ± 2.6 in the negative group (P < 0.0001). The involvement of the cervical spinal cord was found in 88.9% (8/9) of the positive members, but only 11.1% in the negative group (P = 0.009). However, the involvement of the thoracic spinal cord was found in 22.2% of patients in the positive group and 85.7% of patients in the negative members (P = 0.041). In conclusion, male NMO is rare and has a low positive rate of AQP4 antibody. PMID:26213113

  7. Fingolimod suppresses bone resorption in female patients with multiple sclerosis.

    PubMed

    Miyazaki, Yusei; Niino, Masaaki; Kanazawa, Ippei; Suzuki, Masako; Mizuno, Masanori; Hisahara, Shin; Fukazawa, Toshiyuki; Takahashi, Eri; Amino, Itaru; Ochi, Ryutaro; Nakamura, Masakazu; Akimoto, Sachiko; Minami, Naoya; Fujiki, Naoto; Doi, Shizuki; Shimohama, Shun; Terayama, Yasuo; Kikuchi, Seiji

    2016-09-15

    Fingolimod is a sphingosine-1-phosphate receptor agonist used to inhibit the inflammatory activity of multiple sclerosis (MS), and has been shown to suppress osteoporosis in mouse models. In this study, levels of bone turnover markers were quantified in serum and urine samples from MS patients treated with fingolimod. Compared with untreated MS patients and healthy controls, fingolimod-treated MS patients had a significantly lower level of the bone resorption marker type I collagen cross-linked N-telopeptide in urine. This finding was prominent in female but was not seen in male subjects. Our results suggest that fingolimod may have a beneficial effect on bone mass loss in female MS patients. PMID:27609272

  8. Ovarian function in female patients with multibacillary leprosy.

    PubMed

    Neena, Khanna; Ammini, A C; Singh, Manjula; Pandhi, Ravindra Kumar

    2003-06-01

    Eighty six adult female patients with multibacillary leprosy were included to study the sex hormone profile LH, FSH, and prolactin, as well as their gynecological events like menstrual function and fertility status. A third of the patients gave a history of irregularity of periods. The mean levels of LH and FSH were significantly higher in patients with multibacilary leprosy vis-à-vis the controls. Of the 24 married women with irregularity of periods, 12 (50%) were infertile. Seven of these patients had elevated levels of FSH and LH, almost reaching castration levels. PMID:12914132

  9. A longitudinal linear model of patient characteristics to predict failure to attend an inner-city chronic pain clinic

    PubMed Central

    Shaparin, N; White, RS; Andreae, MH; Hall, CB; Kaufman, AG

    2014-01-01

    Patients often fail to attend appointments in chronic pain clinics for unknown reasons. We hypothesized that certain patient characteristics predict failure to attend scheduled appointments pointing to systematic barriers to access chronic pain services for certain underserved populations. We collected retrospective data from a longitudinal observational cohort of patients at an academic pain clinic in Newark, New Jersey. To examine the effect of demographic factors on appointment status, we fit a marginal logistic regression using generalized estimating equations with exchangeable correlation. 1394 patients with 3488 total encounters between January 1, 2006 and December 31, 2009 were included. Spanish spoken as a primary language (alternatively Hispanic or other race) and living between five and ten miles from the clinic were associated with reduced odds of arriving for an appointment; making an appointment for a particular complaint such as cancer pain or back pain, an interventional pain procedure scheduled in connection with the appointment, unemployed status, and continuity of care (as measured by office visit number) were associated with increased odds of arriving. Spanish spoken as primary language and distance to the pain clinic predicted failure to attend a scheduled appointment in our cohort. If these constitute systematic barriers to access, they may be amendable to targeted interventions. Perspective We identified certain patient characteristics, specifically Spanish spoken as primary language and geographic distance from the clinic, that predict failure to attend an inner-city chronic pain clinic. These identified barriers to access chronic pain services may be modifiable by simple cost effective interventions. PMID:24747766

  10. Specificity of L1 peptides versus virus-like particles for detection of human papillomavirus-positive cervical lesions in females attending Engativa Hospital, Bogota, Colombia.

    PubMed

    Urquiza, Mauricio; Sánchez, Ricardo; Amaya, Jairo; León, Sandra; Acosta, Jenny; Patarroyo, Manuel A; Camargo, Milena; Patarroyo, Manuel E

    2008-11-01

    A serological test for the detection of human papillomavirus (HPV) infection in females at risk of developing cervical cancer could be based on conserved L1 peptides with low levels of antigenicity specifically recognized by antibodies from patients with cervical lesions infected with high-risk HPV (HR-HPV) types. The aim was to assess the ability of L1 peptides 18283, 18294, and 18301 compared with the ability of virus-like particles (VLPs) to identify these infections in females. A total of 391 HPV-infected female volunteers were interviewed, and peripheral blood and cervical cells were obtained for detection of anti-HPV antibodies and HPV DNA; all of the patients had a Pap smear test; 287 patients were referred for colposcopy or biopsy, according to gynecological criteria. The level of agreement, as determined by the use of the Lin coefficient (rho value), showed that 75 to 83% of females with HR-HPV DNA-positive cervical lesions had antibodies that recognized VLPs and peptide 18283, 18294, or 18301, while 15 to 23% of the HPV DNA-negative females with a normal cytology had antibodies that recognized these three peptides and 45% had antibodies that recognized VLPs. The rate of agreement between peptides and VLPs for antibody detection was higher for patients with HPV DNA-positive cervical lesions. Peptides 18283, 18294, and 18301 showed similar sensitivities for the detection of HR-HPV DNA-positive cervical lesions and were more specific than VLPs. Peptide 18301 might be detecting protective antibodies in HPV DNA-negative females with atypical squamous cells of undetermined significance. These peptides could be useful for the design of a serology test for the detection of HR-HPV infection in females with cervical lesions and at risk of cervical cancer. PMID:18799706

  11. Patterns of Technology Use in Patients Attending a Cardiopulmonary Outpatient Clinic: A Self-Report Survey

    PubMed Central

    2015-01-01

    Background Self-management education for cardiopulmonary diseases is primarily provided through time-limited, face-to-face programs, with access limited to a small percentage of patients. Telecommunication tools will increasingly be an important component of future health care delivery. Objective The purpose of this study was to describe the patterns of technology use in patients attending a cardiopulmonary clinic in an academic medical center. Methods A prevalence survey was developed to collect data on participant demographics (age in years, sex, and socioeconomic status); access to computers, Internet, and mobile phones; and use of current online health support sites or programs. Surveys were offered by reception staff to all patients attending the outpatient clinic. Results A total of 123 surveys were collected between March and April 2014. Technological devices were a pervasive part of everyday life with respondents engaged in regular computer (102/123, 82.9%), mobile telephone (115/117, 98.3%), and Internet (104/121, 86.0%) use. Emailing (101/121, 83.4%), researching and reading news articles (93/121, 76.9%), social media (71/121, 58.7%), and day-to-day activities (65/121, 53.7%) were the most common telecommunication activities. The majority of respondents reported that access to health support programs and assistance through the Internet (82/111, 73.9%) would be of use, with benefits reported as better understanding of health information (16/111, 22.5%), avoidance of difficult travel requirements and time-consuming face-to-face appointments (13/111, 18.3%), convenient and easily accessible help and information (12/111, 16.9%), and access to peer support and sharing (9/111, 12.7%). The majority of patients did not have concerns over participating in the online environment (87/111, 78.4%); the few concerns noted related to privacy and security (10/15), information accuracy (2/15), and computer literacy and access (2/15). Conclusions Chronic disease burden and

  12. Treatment Adherence of Tuberculosis Patients Attending Two Reference Units in Equatorial Guinea.

    PubMed

    Fagundez, Gabriela; Perez-Freixo, Hugo; Eyene, Juan; Momo, Juan Carlos; Biyé, Lucia; Esono, Teodoro; Ondó Mba Ayecab, Marcial; Benito, Agustín; Aparicio, Pilar; Herrador, Zaida

    2016-01-01

    Equatorial Guinea has one of the highest burden of tuberculosis (TB) in Africa. Incomplete adherence to TB treatment has been identified as one of the most serious remaining problem in tuberculosis control. The following study is aimed at determining the adherence to anti-tuberculosis treatment in Equatorial Guinea and its determinants, as well as at assessing the knowledge of the people about the disease. In this cross-sectional study, participants were recruited by non-probabilistic consecutive sampling amongst patients who attended the reference units for TB in Bata and Malabo between March and July 2015. Socio-demographic and clinical data were collected. Adherence to treatment and knowledge about TB were assessed by Morisky-Green-Levine and Batalla tests and a questionnaire on adherence related factors specifically prepared for this research. Descriptive statistics were computed to summarize the data and bivariate analyses by adherence profile were performed with χ2 test for categorical data. A total of 98 patients with TB were interviewed. 63.27% of interviewees had good knowledge about TB (Batalla test) while 78.57% of respondents were adherent according to the Morisky-Green-Levine test. A low educational level, lack of family support and lack of medical advice about the disease were significantly associated to lower adherence level. Patients with re-infection (due to relapse or treatment failure) and those who have suffered from drug shortages were also less adherents. The National Programme for TB Control should consider improving the early diagnosis and follow-up of TB cases, as well as the implementation of all components of DOTS (Directly observed Treatment, short-course) strategy all over the country. PMID:27622461

  13. Acne in the adult female patient: a practical approach.

    PubMed

    Kamangar, Faranak; Shinkai, Kanade

    2012-10-01

    Acne vulgaris is a common reason why adult women present to dermatologists and can be a clinical challenge to treat. It may also be an important sign of an underlying endocrine disease such as Polycystic Ovary Syndrome (PCOS). Although standard acne therapies can be successfully used to treat acne in adult female patients, hormonal treatment is a safe and effective therapeutic option that may provide an opportunity to better target acne in this population, even when other systemic therapies have failed. In this article, a practical approach to the adult female patient with acne will be reviewed to enhance the dermatologist's ability to use hormonal acne therapies and to better identify and evaluate patients with acne in the setting of a possible endocrine disorder. PMID:22994662

  14. Chikungunya Fever Among Patients with Acute Febrile Illness Attending a Tertiary Care Hospital in Mumbai

    PubMed Central

    Galate, Lata Baswanna; Agrawal, Sachee R; Shastri, Jayanthi S; Londhey, Vikram

    2016-01-01

    Background: Chikungunya fever (CHIK) is an arboviral disease. Dengue fever (DENG) and CHIK are indistinguishable clinically and need to be differentiated by laboratory investigations. Purpose: This study aimed at estimating the seroprevalence of CHIK mono-infection and CHIK and DENG dual infection in suspected patients. We also analyzed the age, sex distribution, joint involvement, and relation of joint movement restriction with visual analog scale (VAS). Materials and Methods: Two hundred patients clinically suspected with DENG and CHIK were enrolled from a Tertiary Care Hospital in Mumbai from April 2012 to October 2013. The detailed history and examination findings were recorded. Serum samples were subjected to DENG and CHIK immunoglobulin G (IgM) enzyme-linked immunosorbent assay (ELISA). Results: The seroprevalence of CHIK was 12.5%. Mono-infection of CHIK was 3%, and CHIK and DENG dual infection was 9.5%. Most affected age group in CHIK cases was 46–60 years wherein female preponderance was seen. All 6 patients with CHIK mono-infection had fever and joint involvement; knee and elbow were the most commonly affected joints. All CHIK patients had VAS score of 6–10 with restricted joint movement. Of the patients with dual infection, the majorities were from 31 to 45 years with male preponderance; all had fever and joint pain mainly affecting knee and elbow. Of patients who had VAS score 6–10 in patients with dual infection, only 5.26% had restricted joint movement. Conclusion: IgM ELISA for Chikungunya infection should be included in the routine laboratory tests for acute febrile illness. PMID:27365916

  15. Reasons for Consultation among Patients attending Primary Healthcare Centres in Oman

    PubMed Central

    Al-Mandhari, Ahmed; Al-Adawi, Samir; Al-Zakwani, Ibrahim; Dorvlo, Atsu; Al-Shafaee, Mohammed

    2013-01-01

    Objectives: Pathways to care or care-seeking, which translate into healthcare utilisation, have been investigated in many parts of the world, but there is a dearth of studies in the Arabian Gulf. The aim of this study was to examine the characteristics of attendees at primary healthcare centres in northern Oman and their reasons for visiting. Methods: Face-to-face interviews were conducted with 676 participants attending 12 primary healthcare centres between June and July 2006. The catchment area was selected to represent the population structure in Oman. The 12-item questionnaire was read to every fifth eligible patient entering each healthcare centre for a routine appointment. Analyses were conducted using univariate statistics. Results: About a third (n = 200; 29.6%) of the participants had a history of chronic illness; 231 (34%) were on regular medications; 211 (31%) were taking part in health education programmes; 130 (19%) were open to complementary medicine. The majority of the participants mentioned physician’s advice (n = 570; 84%) as the strongest reason for seeking consultation. Conversely, physician’s advice was strongly related to particular demographic factors. Conclusion: This observational study identified some characteristics and reasons for visiting healthcare facilities in northern Oman. These are discussed within the context of prevailing sociocultural factors. The implications for the prevention and detection of ill health in Oman are also discussed. PMID:23862030

  16. Urinary antibiotic activity in paediatric patients attending an outpatient department in north-western Cambodia

    PubMed Central

    Emary, Katherine R W; Carter, Michael J; Pol, Sreymom; Sona, Soeng; Kumar, Varun; Day, Nicholas P J; Parry, Christopher M; Moore, Catrin E

    2015-01-01

    Objective Antibiotic resistance is a prominent public and global health concern. We investigated antibiotic use in children by determining the proportion of unselected children with antibacterial activity in their urine attending a paediatric outpatient department in Siem Reap, Cambodia. Methods Caregiver reports of medication history and presence of possible infection symptoms were collected in addition to urine samples. Urine antibiotic activity was estimated by exposing bacteria to urine specimens, including assessment against multiresistant bacteria previously isolated from patients in the hospital (a methicillin-resistant Staphylococcus aureus (MRSA), a multiresistant Salmonella typhi and an extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolate). Results Medication information and urine were collected from 775 children. Caregivers reported medication use in 69.0% of children in the preceding 48 h. 31.7% samples showed antibacterial activity; 16.3% showed activity against a local multiresistant organism. No specimens demonstrated activity against an ESBL-producing E. coli. Conclusions Antibiotics are widely used in the community setting in Cambodia. Parents are often ill-informed about drugs given to treat their children. Increasing the regulation and training of private pharmacies in Cambodia may be necessary. Regional surveillance of antibiotic use and resistance is also essential in devising preventive strategies against further development of antibiotic resistance, which would have both local and global consequences. PMID:25324202

  17. 'Correctable undetected visual acuity deficit' in patients aged 65 and over attending an accident and emergency department.

    PubMed Central

    Reinstein, D Z; Dorward, N L; Wormald, R P; Graham, A; O'Connor, I; Charlton, R M; Yeatman, M; Dodenhoff, R; Touquet, R; Challoner, T

    1993-01-01

    The rate of occurrence of correctable undetected visual acuity deficit (CUVAD) in a population of patients aged 65 and over was investigated, using a pinhole screening method, to compare the sociodemographic and optical eye care habits of patients with or without a functionally significant CUVAD. Of 136 patients 46 (34%) were found to have a functionally significant CUVAD in one or both eyes which was not significantly associated with optician or general practitioner contact, age, sex, social class, living situation, or number of medications. Half the patients with significant CUVAD had not attended for 2 years mainly because of financial considerations. Three quarters attended of their own volition; only one in seven were prompted by opticians' postal invitations. It was concluded that a significant degree of CUVAD could be detected using a simple procedure which can be carried out by general practitioners as part of their general elderly health screen. PMID:8318466

  18. Subtypes of chronic urticaria in patients attending allergy clinics in Venezuela.

    PubMed

    Sánchez-Borges, M; Caballero-Fonseca, F; Capriles-Hulett, A

    2014-11-01

    Chronic urticaria (CU) is one of the most puzzling clinical entities confronted by the medical profession. It is a common motive for consultation, and in a sizable proportion of patients no identifiable cause is evident. Since there are relatively few publications regarding CU in developing countries, we performed a prospective 3-year study on the demographic and clinical features of patients with CU. Four hundred and twenty-three subjects were studied, 52 children and 371 adults, 295 females (69.7%), with a mean age of 38.4 ± 17.8 years. More often, wheals and angioedema (AE) were present on the head, upper and lower limbs and the trunk. AE was present in 162 patients (38.4%). The most frequent subtypes were chronic spontaneous urticaria, aspirin-exacerbated cutaneous disease, dermographic urticaria, and combinations of various subtypes. A better understanding of the characteristics of patients suffering CU is helpful for clinicians dealing with this ailment, and provides guidance for new investigations on its pathogenesis, which will hopefully result in a better management of this vexing condition. PMID:25398164

  19. Indian-born patients attending a sexual health clinic in Australia have differing characteristics to their Australian-born counterparts.

    PubMed

    Sawleshwarkar, S; Kakar, S R; Jones, R; Lagios, K; Mindel, A; Hillman, R J

    2013-12-01

    We report a retrospective cross-sectional study from Western Sydney that assessed the sexual health characteristics of Indian-born patients attending sexual health services compared with Australian-born controls. The sexual health needs of Indian-born patients differed significantly from controls with those born in India reporting more sexual dysfunction and controls having more sexually transmitted infections (STI). These issues should be considered when delivering services to people from culturally and linguistically diverse backgrounds. PMID:24330362

  20. X-chromosome inactivation in female patients with Fabry disease.

    PubMed

    Echevarria, L; Benistan, K; Toussaint, A; Dubourg, O; Hagege, A A; Eladari, D; Jabbour, F; Beldjord, C; De Mazancourt, P; Germain, D P

    2016-01-01

    Fabry disease (FD) is an X-linked genetic disorder caused by the deficient activity of lysosomal α-galactosidase (α-Gal). While males are usually severely affected, clinical presentation in female patients may be more variable ranging from asymptomatic to, occasionally, as severely affected as male patients. The aim of this study was to evaluate the existence of skewed X-chromosome inactivation (XCI) in females with FD, its concordance between tissues, and its contribution to the phenotype. Fifty-six females with FD were enrolled. Clinical and biological work-up included two global scores [Mainz Severity Score Index (MSSI) and DS3], cardiac magnetic resonance imaging, measured glomerular filtration rate, and measurement of α-Gal activity. XCI was analyzed in four tissues using DNA methylation studies. Skewed XCI was found in 29% of the study population. A correlation was found in XCI patterns between blood and the other analyzed tissues although some punctual variability was detected. Significant differences in residual α-Gal levels, severity scores, progression of cardiomyopathy and deterioration of kidney function, depending on the direction and degree of skewing of XCI were evidenced. XCI significantly impacts the phenotype and natural history of FD in females. PMID:25974833

  1. Prevalence of denture-related oral lesions among patients attending College of Dentistry, University of Dammam: A clinico-pathological study

    PubMed Central

    Mubarak, Suhayla; Hmud, Ali; Chandrasekharan, Suresh; Ali, Aiman A.

    2015-01-01

    Background: Heterogeneous groups of oral lesions are likely to develop among denture wearers. The objectives of this study were to determine the exact prevalence of oral lesions among denture wearers attending the clinics of the College of Dentistry, University of Dammam. Materials and Methods: All denture wearers attending the dental clinics in the period between January 2012 and April 2013 were included in this study. Of the total 210 patients, 166 (79%) were males and 44 (21%) were females. Comprehensive oral examination was performed for all patients. Any denture-induced lesion was biopsied. Data collected were analyzed using SPSS program. Results: Oral lesions were found in 20.5% of the cases under study (43 out of the total 210 denture wearers). Denture-induced fibrous hyperplasia was the most common type of lesion detected (41.9%). A significant correlation (P = 0.004) was found between the type of denture and oral lesions in this study. Conclusion: The prevalence of denture-induced oral lesions was found to differ significantly from that reported in other studies. The diversity of these lesions among different studies depends on the quality and materials of dentures delivered, the techniques used, and the methods of patients’ instructions adopted. PMID:26759806

  2. Body Image and the Female Adolescent Oncology Patient.

    PubMed

    Burg, Alison Joy

    2016-01-01

    Female adolescent oncology patients undergo many physical changes throughout treatment that have challenging psychological, emotional, and social implications. Body image for this population is a subject that tends to be overlooked in the midst of the cancer experience. This article will examine the complex concept of body image and discuss why female adolescent patients are at such high risk for negative body image. Assessment and care strategies are needed to foster a positive body image, resiliency, and overall well-being. Although survivorship studies may offer insightful information about the effects of the cancer journey on long-term body image, focus should be on prevention and holistic care as part of the treatment itself. The health care team, especially nursing professionals, should acknowledge, recognize, and address this vital issue as a critical part of oncology care. PMID:25643971

  3. [Community-acquired bacteremia in adult patients attending the emergency service of a teaching hospital].

    PubMed

    Artico, Muriel J; Rocchi, Marta; Gasparotto, Ana; Ocaña Carrizo, Valeria; Navarro, Mercedes; Mollo, Valeria; Avilés, Natalia; Romero, Vanessa; Carrillo, Sonia; Monterisi, Aída

    2012-01-01

    Bacteremia is an important cause of morbimortality. This study describes the episodes of community-acquired bacteremia in adult patients registered at our hospital. Between January 2005, and December 2009, 271 episodes were studied. The diagnostic yield of blood cultures was 13.5 %. A total of 52 % of patients were male and 48 % female. The mean age was 60. The most frequent comorbidities were: diabetes (21 %), neoplasia (18 %), cardiopathy (11 %), and HIV infection (8 %). The focus was- respiratory (21 %), urinary (15 %), cutaneous (9 %), and others (13 %). Gram-positive bacteria prevailed (51.4%). The most frequent microorganisms were Escherichia coli (25 %), Streptococcus pneumoniae (22.9 %), and Staphylococcus aureus (12.3 %). Bacteremia was polymicrobial in 7 % of the cases. Thirty three percent of E. coli isolates were resistant to ciprofloxacin and 6 % to ceftazidime. Fourteen percent of S. aureus strains were resistant to oxacillin whereas only 7 % of S. pneumoniae expressed high resistance to penicillin with MICs = 2 ug/ml, according to meningitis breakpoints. PMID:22610291

  4. Staff perceptions on patient motives for attending GP-led urgent care centres in London: a qualitative study

    PubMed Central

    Greenfield, Geva; Ignatowicz, Agnieszka; Gnani, Shamini; Bucktowonsing, Medhavi; Ladbrooke, Tim; Millington, Hugh; Car, Josip

    2016-01-01

    Objectives General practitioner (GP)-led urgent care centres were established to meet the growing demand for urgent care. Staff members working in such centres are central in influencing patients’ choices about which services they use, but little is known about staff perceptions of patients’ motives for attending urgent care. We hence aimed to explore their perceptions of patients’ motives for attending such centres. Design A phenomenological, qualitative study, including semistructured interviews. The interviews were analysed using thematic content analysis. Setting 2 GP-led urgent care centres in 2 academic hospitals in London. Participants 15 staff members working at the centres including 8 GPs, 5 emergency nurse practitioners and 2 receptionists. Results We identified 4 main themes: ‘Confusion about choices’, ‘As if increase of appetite had grown; By what it fed on’, ‘Overt reasons, covert motives’ and ‘A question of legitimacy’. The participants thought that the centres introduce convenient and fast access for patients. So convenient, that an increasing number of patients use them as a regular alternative to their community GP. The participants perceived that patients attend the centres because they are anxious about their symptoms and view them as serious, cannot get an appointment with their GP quickly and conveniently, are dissatisfied with the GP, or lack self-care skills. Staff members perceived some motives as legitimate (an acute health need and difficulties in getting an appointment), and others as less legitimate (convenience, minor illness, and seeking quicker access to hospital facilities). Conclusions The participants perceived that patients attend urgent care centres because of the convenience of access relative to primary care, as well as sense of acuity and anxiety, lack self-care skills and other reasons. They perceived some motives as more legitimate than others. Attention to unmet needs in primary care can help in

  5. Posturographic destabilization in eating disorders in female patients exposed to body image related phobic stimuli.

    PubMed

    Forghieri, M; Monzani, D; Mackinnon, A; Ferrari, S; Gherpelli, C; Galeazzi, G M

    2016-08-26

    Human postural control is dependent on the central integration of vestibular, visual and proprioceptive inputs. Psychological states can affect balance control: anxiety, in particular, has been shown to influence balance mediated by visual stimuli. We hypothesized that patients with eating disorders would show postural destabilization when exposed to their image in a mirror and to the image of a fashion model representing their body ideal in comparison to body neutral stimuli. Seventeen females patients attending a day centre for the treatment of eating disorders were administered psychometric measures of body dissatisfaction, anxiety, depression and underwent posturographic measures with their eyes closed, open, watching a neutral stimulus, while exposed to a full length mirror and to an image of a fashion model corresponding to their body image. Results were compared to those obtained by eighteen healthy subjects. Eating disordered patients showed higher levels of body dissatisfaction and higher postural destabilization than controls, but this was limited to the conditions in which they were exposed to their mirror image or a fashion model image. Postural destabilization under these conditions correlated with measures of body dissatisfaction. In eating disordered patients, body related stimuli seem to act as phobic stimuli in the posturographic paradigm used. If confirmed, this has the potential to be developed for diagnostic and therapeutic purposes. PMID:27397012

  6. Prevalence and etiologic agents of female reproductive tract infection among in-patients and out-patients of a tertiary hospital in Benin city, Nigeria

    PubMed Central

    Omoregie, Richard; Egbe, Christopher Aye; Igbarumah, Isaac Ohiorenuan; Ogefere, Helen; Okorie, Evelyn

    2010-01-01

    Background: Reproductive tract infections are public health problems in women of reproductive age and can result in serious consequences if not treated. Aims: To determine the prevalence and causes of reproductive tract infections among in-patients and out-patients attending a tertiary health institution in Benin City. The antimicrobial susceptibility profiles of bacterial agents will also be determined. Patients and Methods: High vaginal swabs or endocervical swabs and blood were collected from 957 patients consisting of 755 out-patients and 202 in-patients. The swabs were processed and microbial isolates identified using standard technique. Disc susceptibility tests were also performed on microbial isolates. The blood samples were used for serological diagnosis of syphilis. Results: There was no significant difference in the prevalence of female reproductive tract infections between in-patients (52.48%) and out-patients (47.02%), although in-patients showed a significantly higher risk of developing mixed infections (in-patients vs. out-patients; 34.91% vs. 22.25%, OR = 1.873 95% CI = 1.169, 3.001; P = 0.01). Candida albicans was the most prevalent etiologic agent among out-patients studied while Staphylococcus aureus was the most prevalent etiologic agent among in-patients. Trichomonas vaginalis was observed only among out-patients. Ceftriaxone, ciprofloxacin and ofloxacin were the most active antibacterial agents. Syphilis was not detected in any patient. Conclusion: An overall prevalence of 48.17% of female reproductive tract infection was observed among the study population. Although there was no significant difference between in-patients and out-patients, in-patients appeared to have 1-3-fold increase risk of developing mixed infections. The most prevalent etiologic agent differs between in-patients and out-patients. Despite the high activity of ceftriaxone, ciprofloxacin and ofloxacin against bacterial isolates from both in-patients and out-patients, prudent

  7. Female sexual dysfunction in patients with substance-related disorders

    PubMed Central

    Diehl, Alessandra; da Silva, Rosiane Lopes; Laranjeira, Ronaldo

    2013-01-01

    OBJECTIVE: To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit. METHODS: This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerström Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered. RESULTS: The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerström Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence. CONCLUSIONS: Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use. PMID:23525317

  8. Chronic facial pain in the female patient: treatment updates.

    PubMed

    Stavropoulos, Franci; Hastie, Barbara A

    2007-05-01

    Over the past decade, gender-related differences in pain and analgesia have been examined in experimental settings with conflicting evidence on whether men and women differ in their response to pain. New advances in research have begun to investigate the influence of genetic factors in moderating sex differences in analgesic response. This article provides oral and maxillofacial surgeons with evidence-based data on the issues of chronic pain between the sexes to suggest alternative approaches to the management of pain in their male and female patients. PMID:18088882

  9. Inhaled corticosteroids can reduce osteoporosis in female patients with COPD

    PubMed Central

    Liu, Shih-Feng; Kuo, Ho-Chang; Liu, Guan-Heng; Ho, Shu-Chen; Chang, Huang-Chih; Huang, Hung-Tu; Chen, Yu-Mu; Huang, Kuo-Tung; Chen, Kuan-Yi; Fang, Wen-Feng; Lin, Meng-Chih

    2016-01-01

    Background Whether the use of inhaled corticosteroids (ICSs) in patients with COPD can protect from osteoporosis remains undetermined. The aim of this study is to assess the incidence of osteoporosis in patients with COPD with ICS use and without. Patients and methods This is a retrospective cohort and population-based study in which we extracted newly diagnosed female patients with COPD between 1997 and 2009 from Taiwan’s National Health Insurance (TNHI) database between 1996 and 2011 (International Classification of Diseases, Ninth Revision – Clinical Modification [ICD-9-CM] 491, 492, 496). The patients with COPD were defined by the presence of two or more diagnostic codes for COPD within 12 months on either inpatient or outpatient service claims submitted to TNHI. Patients were excluded if they were younger than 40 years or if osteoporosis had been diagnosed prior to the diagnosis of COPD and cases of asthma (ICD-9 CM code 493.X) before the index date. These enrolled patients were followed up till 2011, and the incidence of osteoporosis was determined. The Cox proportional hazards regression model was also used to estimate hazard ratios (HRs) for incidences of lung cancer. Results Totally, 10,723 patients with COPD, including ICS users (n=812) and nonusers (n=9,911), were enrolled. The incidence rate of osteoporosis per 100,000 person years is 4,395 in nonusers and 2,709 in ICS users (HR: 0.73, 95% confidence interval [CI]: 0.63–084). The higher ICS dose is associated with lower risk of osteoporosis (0 mg to ≤20 mg, HR: 0.84, 95% CI: 0.69–1.04; >20 mg to ≤60 mg, HR: 0.78, 95% CI: 0.59–1.04; and >60 mg, HR: 0.72, 95% CI: 0.55–0.96; P for trend =0.0023) after adjusting for age, income, and medications. The cumulative osteoporosis probability significantly decreased among the ICS users when compared with the nonusers (P<0.001). Conclusion Female patients with COPD using ICS have a dose–response protective effect for osteoporosis. PMID:27478374

  10. Treatment of Osteitis Pubis in Non-Athlete Female Patients

    PubMed Central

    Kavroudakis, E; Karampinas, P.K; Evangelopoulos, D.S; Vlamis, J

    2011-01-01

    Background: Osteitis pubis represents a non-infectious inflammation of the pubic symphysis causing varying degrees of lower abdominal and pelvic pain. Although, the disease is believed to affect mainly young athletic patients, it is also encountered in other specific patient groups. Both conservative and surgical treatment options are available. While for elite athletes surgical treatment is indicated, leading to fast pain relief and mobilization, for non-athletic patients no clear indication can be established. Methods: Eight non-athletic women with osteitis pubis, referred to our Department for treatment, were evaluated. All were initially treated conservatively with bed rest, per os non steroidal anti-inflammatory drugs and physical therapy. Results: Seven patients improved significantly with conservative treatment while one displayed no improvement and was treated surgically with arthrodesis. Conclusion: We conclude that, for non-athletic female patients suffering from osteitis pubis, surgery is rarely required and that conservative treatment by means of non steroidal anti inflammatory drugs and physical modalities represents a fair option regarding pain and limitation of everyday activity. PMID:21966337

  11. Side-hairline Correction in Korean Female Patients

    PubMed Central

    2015-01-01

    Background: To investigate the proper modifications and usefulness of side-hairline correction surgery in Korean female patients depending on different zygomatic bone structures. Methods: Different zygomatic bone structures were classified according to their maximum transverse width among 310 cases of hairline correction surgery in Korean women. The widest transverse width was located on the anterior zygomatic malar area in type 1, on the mid-zygomatic arch in type 2, and on the posterior zygomatic arch in type 3; there was no difference in the transverse width between the anterior and posterior zygomatic arch in type 4. Various modifications of side-hairline correction surgery were performed among the 310 cases according to the zygomatic bone classification. Results: Among 310 patients, 74 had a type 1 zygomatic structure, 106 had type 2, 46 had type 3, and 50 had type 4. Thirty-four patients exhibited different left and right transverse widths: type 1 + 2 (n = 26), type 2 + 3 (n = 6), type 1 + 3 (n = 1), and type 3 + 4 (n = 1). Satisfactory results were obtained in all patients without noticeable side effects. A minor touch-up procedure was performed in 14 patients to achieve density reinforcement 10 months postoperatively, and all 14 patients expressed satisfaction with the results. Conclusions: In East Asian patients, both side-hairline correction surgery and zygoma reduction can be considered eligible treatment options for the purpose of midface slimming. Especially in patients with a type 3 zygomatic bone structure, side-hairline correction surgery may be more effective than zygoma reduction surgery for midface slimming. PMID:25878947

  12. Appointments failure among female patients at a dental school clinic in Saudi Arabia.

    PubMed

    Albarakati, Sahar F

    2009-09-01

    The aim of the study was to assess the factors and reasons responsible for failed appointments among female patients attending a dental school clinic. A cross-sectional survey was conducted at the College of Dentistry in Riyadh city on 200 patients who failed to keep their appointments at least one time. The data were collected using a structured, pretested questionnaire through a telephone interview method from January through May 2007. The selected sample was in the age group of fourteen years and older. The response rate was 86 percent. The results illustrated that most of the patients who broke their appointments were married, housewives, above forty years in age, and of low to middle socioeconomic status. It was found that the most common reasons for failed appointments were fasting in the Holy Month of Ramadan (79.1 percent) followed by transportation difficulty (76.2 percent), inconvenient appointment time (65.1 percent), and dissatisfaction of communication with booking area (54.1 percent). PMID:19734254

  13. Exploring the Reality of Using Patient Experience Data to Provide Resident Feedback: A Qualitative Study of Attending Physician Perspectives

    PubMed Central

    Campbell, Steffanie; Goltz, Heather Honoré; Njue, Sarah; Dang, Bich Ngoc

    2016-01-01

    Introduction: Little is known about the attitudes of faculty and residents toward the use of patient experience data as a tool for providing resident feedback. The purpose of this study was to explore the attitudes of teaching faculty surrounding patient experience data and how those attitudes may influence the feedback given to trainees. Methods: From July 2013 to August 2013, we conducted in-depth, face-to-face, semistructured interviews with 9 attending physicians who precept residents in internal medicine at 2 continuity clinics (75% of eligible attendings). Interviews were coded using conventional content analysis. Results: Content analysis identified six potential barriers in using patient experience survey data to provide feedback to residents: 1) perceived inability of residents to learn or to incorporate feedback, 2) punitive nature of feedback, 3) lack of training in the delivery of actionable feedback, 4) lack of timeliness in the delivery of feedback, 5) unclear benefit of patient experience survey data as a tool for providing resident feedback, and 6) lack of individualized feedback. Conclusion: Programs may want to conduct an internal review on how patient experience data is incorporated into the resident feedback process and how, if at all, their faculty are trained to provide such feedback. PMID:27400180

  14. Clinical profile of HIV infected patients attending a HIV referral clinic in Pune, India

    PubMed Central

    Antwal, Megha; Gurjar, Rohan; Chidrawar, Shweta; Pawar, Jyoti; Gaikwad, Sunil; Panchal, Narayan; Kale, Varsha; Thakar, Madhuri; Risbud, Arun; Tripathy, Srikanth

    2014-01-01

    Background & objectives: Human immunodeficiency virus (HIV) has infected several million individuals in India. Various interventions have been implemented for early detection and prevention of transmission of HIV infection. This has progressively changed the clinical profile of HIV infected individuals and this study documents the clinical presentation of individuals positive for HIV in 2010, in Pune, Maharashtra, India. Methods: This cross-sectional study included subjects who had come to the HIV referral clinic for HIV testing from January to December 2010. Children as well as individuals with indeterminate HIV result were excluded from the study, and data for 1546 subjects were finally analysed. Results: The HIV positivity rate among all referred cases for the year 2010 was 35 per cent (male 55% and females 45%). The median age (Q1, Q3) was 31 (25.75, 39) yr. The median CD4 cell count for all HIV infected individuals (whose CD4 count was available n= 345) was 241 cells/µl and for asymptomatic HIV infected individuals was 319 cells/µl. There were 673 (43.5%) symptomatic and 873 (56.5%) asymptomatic participants. Fever, breathlessness, cough with expectoration, weight loss, loss of appetite, generalized weakness, pallor and lymphadenopathy (axillary and cervical) were found to be associated (P< 0.001) with HIV positivity. On multivariate analysis, history of Herpes zoster [AOR 11.314 (6.111-20.949)] and TB [AOR 11.214 (6.111-20.949)] was associated with HIV positivity. Interpretation & conclusions: Signs and symptoms associated with HIV positivity observed in this study can be used by health care providers to detect HIV infection early. Moreover, similar to HIV testing in patients with tuberculosis, strategies can be developed for considering Herpes zoster as a predictor of HIV infection. PMID:25297361

  15. Evaluation of control of blood pressure in chronic kidney disease patients with hypertension attending echo-lab of Nepal Medical College Teaching Hospital.

    PubMed

    Shrestha, B; Dhungel, S

    2012-06-01

    Hypertension and Chronic kidney disease (CKD) are common in Nepal. Control of blood pressure (BP) in general hypertensive patients is poor. Evaluation of adequacy of BP control in CKD patients with hypertension is rare. All consecutive indoor patients (52) with CKD and hypertension, attending echo-lab of Nepal Medical College Teaching Hospital during prospective study of 3 years period from 16th April 2008 to 15th April 2011, were evaluted. Mean age was 45.3 +/- 16.7 years. Male female ratio was 8:5. Brahman and Chhetri (22, 42.3%) were the usual sufferers. There were two peaks in the age group wise distribution; one in age group 20-29 years and the next in 50-59 years. One hypertensive patient's BP was normalized after starting hemodialysis without antihypertensive therapy and was excluded from this study. Others' BP (n = 51) were followed up during admission for the evaluation of the adequacy of their BP control and their antihypertensive medications were reviewed. The control of hypertension in CKD patients was difficult. More than two third of the patients (68.6%) had BP > 140/90 mm Hg. Intensive BP control was present in less than one tenth (7.9%) of the patients. In comparison to intensive group, uncontrolled group received more antihypertensive agents (3.0 +/- 1.3 vs. 2.0 +/- 0.8, p < 0.05). Amlodipine (39, 76.5%) and frusemide (39, 76.5%) were very popular antihypertensives used followed by Prazocin (20, 39.2%) and Metoprolol (11, 21.6%). Despite good efforts, BP control of Nepalese CKD patients with hypertension, were poor. PMID:23671961

  16. Cluster Headache: Special Considerations for Treatment of Female Patients of Reproductive Age and Pediatric Patients.

    PubMed

    VanderPluym, Juliana

    2016-01-01

    Cluster headache is a rare disorder that is more common in adult male patients. It has a unique phenotype of unilateral, severe, to very severe headaches lasting 15 to 180 min with ipsilateral autonomic symptoms. Time to correct diagnosis can be protracted. A number of treatment options exist for the standard cluster headache patient, but special considerations must be made for female patients of reproductive age and pediatric patients. The objective of this article is to explore the current literature pertaining to special considerations in cluster headache management, including treatment of pregnant or breastfeeding patients and pediatric patients. PMID:26711274

  17. The Effect of Attending Good Psychiatric Management (GPM) Workshops on Attitudes Toward Patients With Borderline Personality Disorder.

    PubMed

    Keuroghlian, Alex S; Palmer, Brian A; Choi-Kain, Lois W; Borba, Christina P C; Links, Paul S; Gunderson, John G

    2016-08-01

    The effect that attending a 1-day workshop on Good Psychiatric Management (GPM) had on attitudes about borderline personality disorder (BPD) was assessed among 297 clinicians. Change was recorded by comparing before and after scores on a 9-item survey previously developed to assess the effects of workshops on Systems Training for Emotional Predictability and Problem Solving (STEPPS). Participants reported decreased inclination to avoid borderline patients, dislike of borderline patients, and belief that BPD's prognosis is hopeless, as well as increased feeling of competence, belief that borderline patients have low self-esteem, feeling of being able to make a positive difference, and belief that effective psychotherapies exist. Less clinical experience was related to an increased feeling of competence and belief that borderline patients have low self-esteem. These findings were compared to those from the STEPPS workshop. This assessment demonstrates GPM's potential for training clinicians to meet population-wide needs related to borderline personality disorder. PMID:26111249

  18. Early and Mid-term Outcomes in Female Patients Undergoing Isolated Conventional Coronary Surgery

    PubMed Central

    Erguneş, Kazim; Yilik, Levent; Yetkin, Ufuk; Lafcı, Banu; Bayrak, Serdar; Ozpak, Berkan; Gurbuz, Ali

    2014-01-01

    Introduction: Several observational studies comparing outcomes between female and male patients after coronary artery bypass grafting (CABG) have shown that operative mortality rate is higher among female patients than in male patients. However, some conflicting studies report that early mortality among female patients is equivalent to that among male patients. We investigated predictive factors of morbidity, mortality and survival in female patients undergoing isolated conventional CABG. Methods: Between January 2002 and December 2009, 1657 patients underwent isolated conventional CABG in our clinic. 21.8% (n=361) of patients were female and 78.2% (n=1296) males. Results: Advanced age (P<0.0001), hypertension (P<0.0001), diabetes (P<0.0001), and hyperlipidemia (P<0.0001) were the independent predictive factors among female patients. Mean in-hospital mortality rates were 5.8% and 3.2%; for females and males, respectively (P=0.029). Prolonged ventilatory support (P=0.009) and postoperative atrial fibrillation (P=0.049) were the independent predictive factors of in-hospital mortality in female patients. Cardiopulmonary bypass time (P=0.041), prolonged ventilatory support (P<0.0001), and postoperative atrial fibrillation (P=0.031) were the independent predictive factors of in-hospital mortality in male patients. Mean follow-up was 47.51±25.06 months and 48.42±25.21 months among female and male patients (P=0.820). In follow-up, mortality rate was 6.1% (n=22) among female patients and 4.6% (n=60) among male patients (P=0.272). Left internal thoracic artery (LITA) usage (P=0.001) was the independent predictive factor of survival in female patients. Conclusion: In-hospital mortality rate was higher in female patients. Length of ICU and hospital stay, and mid-term survival was similar between female and male patients. PMID:25031826

  19. Female Patients Require a Higher Propofol Infusion Rate for Sedation.

    PubMed

    Maeda, Shigeru; Tomoyasu, Yumiko; Higuchi, Hitoshi; Honda, Yuka; Ishii-Maruhama, Minako; Miyawaki, Takuya

    2016-01-01

    Sedation may minimize physiologic and behavioral stress responses. In our facility, the infusion rate of propofol is adjusted according to the bispectral index (BIS) in all cases of implant-related surgery; multivariate analysis of retrospective data enabled us to extract independent factors that affect the dose of propofol in sedation that are considered useful indicators for achieving adequate sedation. The study population comprised all patients undergoing implant-related surgery under intravenous sedation in Okayama University Hospital from April 2009 to March 2013. The infusion rate of propofol was adjusted to maintain the BIS value at 70-80. The outcome was the average infusion rate of propofol, and potential predictor variables were age, sex, body weight, treatment time, and amount of midazolam. Independent variables that affected the average infusion rate of propofol were extracted with multiple regression analysis. One hundred twenty-five subjects were enrolled. In the multiple regression analysis, female sex was shown to be significantly associated with a higher average infusion rate of propofol. Females may require a higher infusion rate of propofol than males to achieve adequate sedation while undergoing implant-related surgery. PMID:27269663

  20. Prevalence of Hepatitis C Virus Antibody in Patients With Sexually Transmitted Diseases Attending a Harrisburg, PA, STD Clinic

    PubMed Central

    Jones, Sharon; Weber, Daniel I.; LeBar, William D.; Heitjan, Daniel F.; Kopreski, Mary Magdalene C.; Curcio, Frederick D.

    1994-01-01

    Objective: The prevalence of hepatitis B and hepatitis C in a sexually transmitted disease (STD) clinic population was studied, along with the prevalence of various STD agents, in an attempt to identify possible STD markers for the hepatitis C virus and help delineate the role of hepatitis C as an STD. The hepatitis C antibody rates found in the STD clinic were also compared with those found among patients attending a local OB/GYN clinic and those enrolled in a blood donor program, all from the same geographical area. Methods: A total of 150 women attending an STD clinc were examined for each of the following agents: Chlamyadia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody, and hepatitis C virus antibody. Additionally, several patients who signed informed consent to be evaluated for human immunodeficiency virus (HIV) antibody were tested by an enzyme immunoassay (EIA) screen method. The prevalence of each agent was then compared with the other agents. Results: The overall prevalence rates detected were as follows: hepatitis B 16%, hepatitis C 4%, chlamydia 18.7%, gonorrhea 7.4%, syphilis 0.7%, and HIV 0%. Hepatitis C antibody was detected in 4% of patients in the STD clinic, 0.76% of volunteer blood donors from central Pennsylvania, and 0% of patiants studied from the Harrisburg Hospital (Harrisburg, PA) prentatal population. Conclusions: This screening study reveals an association between attending a Harrisburg, PA, area STD clinic and having an increased prevalence of hepatitis C antibody, but larger matched control studies will be needed to help clarify sexual transmission as a mode of transmission for the hepatitis C virus. PMID:18475350

  1. The prolonged clotting time in two female patients with thromboangiitis obliterans

    PubMed Central

    Dang, Yiping; Xia, Yin; Li, Yiqing; Yu, DannyCW

    2013-01-01

    Thromboangiitis obliterans (TAO), also known as Buerger's disease, is segmental non-atherosclerotic inflammatory disease, which affects the small and medium-sized peripheral arteries, veins and nerves of young adult smokers. The paper reports two TAO female patients, 26-year-old and 42-year-old, with prolonged clotting time. We compared 13 male patients and 2 female patients with TAO. The prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) were normal in the male patients, whereas the clotting times were prolonged in the female patients. Coagulation tests including PT, APTT and TT evaluation could be the potential markers to female patients with TAO. PMID:23749821

  2. A Nutrition Screening Form for Female Infertility Patients.

    PubMed

    Langley, Susie

    2014-12-01

    A Nutrition Screening Form (NSF) was designed to identify lifestyle risk factors that negatively impact fertility and to provide a descriptive profile of 300 female infertility patients in a private urban infertility clinic. The NSF was mailed to all new patients prior to the initial physician's visit and self-reported data were assessed using specific criteria to determine if a nutrition referral was warranted. This observational study revealed that 43% of the women had a body mass index (BMI) <20 or ≥25 kg/m(2), known risks for infertility. Almost half reported a history of "dieting" and unrealistic weight goals potentially limiting energy and essential nutrients. A high number reported eating disorders, vegetarianism, low fat or low cholesterol diets, and dietary supplement use. Fourteen percent appeared not to supplement with folic acid, 13% rated exercise as "extremely" or "very active", and 28% reported a "high" perceived level of stress. This preliminary research demonstrated that a NSF can be a useful tool to identify nutrition-related lifestyle factors that may negatively impact fertility and identified weight, BMI, diet, exercise, and stress as modifiable risk factors deserving future research. NSF information can help increase awareness among health professionals and patients about the important link between nutrition, fertility, and successful reproductive outcomes. PMID:26067073

  3. Religiosity and adherence to antiretroviral therapy among patients attending a public hospital-based HIV/AIDS clinic in Uganda.

    PubMed

    Kisenyi, Rita N; Muliira, Joshua K; Ayebare, Elizabeth

    2013-03-01

    In Uganda, the prevalence of non-adherence to antiretroviral therapy (ART) by HIV/AIDS patients remains high and sometimes this is blamed on patients' religious behavior. A descriptive design was used to examine the relationship between religiosity and ART adherence in a sample of 220 patients attending a HIV/AIDS clinic in a Ugandan public hospital. Participants who self-identified as Pentecostal and Muslim had the highest percentage of members with high religiosity scores and ART adherence. Among Muslim participants (34), 82% reported high religiosity scores and high levels of ART adherence. Of the fifty Pentecostals participants, 96% reported high religiosity scores and 80% reported high levels of ART adherence. Correlation analysis showed a significant relationship between ART adherence and religiosity (r = 0.618, P ≤ 0.01). Therefore, collaboration between religious leaders and HIV/AIDS healthcare providers should be encouraged as one of the strategies for enhancing ART adherence. PMID:21360222

  4. Outcome of a cohort of 300 patients with systemic lupus erythematosus attending a dedicated clinic for over two decades

    PubMed Central

    Moss, K; Ioannou, Y; Sultan, S; Haq, I; Isenberg, D

    2002-01-01

    Objective: To examine the mortality rate and causes of death in a cohort of 300 patients with systemic lupus erythematosus (SLE). Methods: A retrospective analysis was performed on all patients attending the SLE clinic between 1978 and 2000. Information was obtained on those patients lost to follow up. Cause of death was analysed and categorised as early (<5 years after diagnosis of SLE) and late (>5 years after diagnosis of SLE). Standardised mortality rates were obtained. Results: The patients were followed up for a median of 8.3 years. Seventy three (24%) patients were no longer followed up at the end of the study period, of whom 41 (14%) had died. Of the 32 patients lost to follow up, 14 were being actively followed up within the UK, 16 were followed up outside the UK, and two patients were untraceable. The most common cause of death was malignancy, which accounted for eight (20%) deaths, followed by infection and vascular disease, which accounted for seven (17%) deaths each. Conclusions: Malignancy was the most common cause of death. Cause of death varied depending on disease duration. Forty per cent of early deaths were due to SLE related renal disease, whereas 23% of late deaths were due to vascular causes. Death due to infection occurred throughout the follow up period. There was a fourfold increased risk of death in our cohort of patients with SLE compared with the general population. PMID:11959764

  5. Poor glycaemic control in Brazilian patients with type 2 diabetes attending the public healthcare system: a cross-sectional study

    PubMed Central

    Viana, Luciana V; Leitão, Cristiane B; Kramer, Caroline K; Zucatti, Alessandra T N; Jezini, Deborah L; Felício, João; Valverde, Ana B; Chacra, Antonio R; Azevedo, Mirela J; Gross, Jorge L

    2013-01-01

    Objectives To describe the clinical profile of Brazilian patients with type 2 diabetes attending the public healthcare system and identify factors associated with poor glycaemic control. Design Cross-sectional study. Setting 14 centres in five regions of Brazil, including primary care units and outpatient clinics of University Hospitals. Participants Patients with type 2 diabetes attending outpatient clinics of public healthcare system. Main outcome measured Glycated haemoglobin (HbA1c), centrally measured by high-performance liquid chromatography (National Glycohemoglobin Standardization Program certified). Results A total of 5750 patients aged 61±10 years, with 11±8 years of diabetes duration (66% women, 56% non-white, body mass index: 28.0±5.3 kg/m2) were analysed. Mean HbA1c was 8.6±2.2%, and median HbA1c was 8.1% (6.9% to 9.9%). HbA1c <7% was observed in only 26% of patients. Mean HbA1c was higher (p < 0.01) in the North (9.0±2.6%) and Northeast (8.9±2.4%) than in the Midwest (8.1±2%), Southeast (8.4±2.1%) and South regions (8.3±1.9%). Using the cut-off value of HbA1c above the median, age (0.986 (0.983 to 0.989)), white ethnicity (0.931 (0.883 to 0.981)) and being from Midwest region (0.858 (0.745 to 0.989)) were protective factors, while diabetes duration (1.015 (1.012 to 1.018)), use of insulin (1.710 (1.624 to 1.802)) and living in the Northeast region (1.197 (1.085 to 1.321)) were associated with HbA1c >8%. Conclusions The majority of Brazilian patients with type 2 diabetes attending the public healthcare system had HbA1c levels above recommended targets. The recognition of Northeast residents and non-white patients as vulnerable populations should guide future policies and actions to prevent and control diabetes. PMID:24052610

  6. Common opportunistic infections and their CD4 cell correlates among HIV-infected patients attending at antiretroviral therapy clinic of Gondar University Hospital, Northwest Ethiopia

    PubMed Central

    2013-01-01

    Background Human immunodeficiency virus (HIV) pandemic is among the greatest health crises ever faced by humanity. Morbidity and mortality in HIV disease is due to immunosuppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. This study was aimed to assess the prevalence and CD4 correlates of OIs among adult HIV-infected patients attending at Gondar University Hospital. Methods Cross sectional study was conducted on 360 adult HIV-infected patients attending antiretroviral therapy clinic from February 2012-April 2012. Patients’ OI status was determined through clinical diagnosis and laboratory investigations. CD4 count was determined using flow cytometry technique. Sociodemographic and clinical data were obtained from interview and patients’ medical records. Bivariate and multivariate logistic regression analysis was done using SPSS version 16 statistical soft ware and odds ratio was used as the measure of association. P-value less than 0.05 was considered statistically significant for all tests. Results In this study, 360 HIV-infected patients were included; of whom (n = 216/360, 60%) were females. The majority of patients (n = 153/360, 42.5%) were 25-34 years old with mean age of 35.5+ 8.8 standard deviation. The overall prevalence of OIs was (n = 71/360, 19.7%). Tuberculosis (n = 35/360, 9.72%) followed by oral candidiasis (n = 18/360, 5%) and diarrhea (n = 12/360, 3.3%) were the most frequently observed OIs. CD4 count less than 200/mm3 (OR = 4.933, P < 0.001), World Health Organization (WHO) clinical stage III (OR = 9.418, P < 0.001) and IV (OR = 22.665, P < 0.001) were found to have strong association with acquisition of OIs. Conclusions Tuberculosis, oral candidiasis and diarrhea were the leading OIs encountered by HIV-infected patients. CD4 count less than 200/mm3 and advanced WHO clinical stages of the disease were found to be predictors of OIs

  7. Gynaecological Prolapse Surgery in Very Old Female Patients

    PubMed Central

    Mothes, A. R.; Lehmann, T.; Kwetkat, A.; Radosa, M. P.; Runnebaum, I. B.

    2016-01-01

    Background: The aim of this study is to compare very elderly female patients with a younger control group after prolapse surgery with regard to co-morbidity and complications. Method: In a case-control design, the consecutive data of patients after prolapse surgery at the age of over 80 years and those of a control group were analysed by means of the Clavien-Dindo (CD) classification of surgical complications, the Charlson Comorbidity Index and the Cumulative Illness Rating Scale Geriatrics (CIRS-G). Statistics: Studentʼs t, Fisherʼs exact and Mann-Whitney U tests. Results: The analysis comprised n = 57 vs. n = 60 operations. In the very elderly patients there was often a grade IV prolapse (p < 0.001), apical fixations were more frequent (p < 0.001), but the operating times were not different. In the very elderly patients 21 % CD II+III complications were observed, in the control group 6.6 % (p = 0.031). No CD IV and V complications occurred in either group, the duration of inpatient stay amounted to 5 (± 1) vs. 4.1 (± 0.8; p < 0.001) days, the very elderly patients needed an inpatient follow-up more frequently (p < 0.001). The co-morbidities of the very elderly patients differed from those of the control group in number (median 2.0 vs. 1.5; p < 0.001), in CIRS-G (4.1 ± 2.2 vs. 2.4 ± 1.7; p < 0.01) and in Charlson Index (1.6 ± 1.6 vs. 0.5 ± 0.7; p < 0.001). Conclusions: A prolapse in very elderly women can be safely managed by surgery. In no case did the complications require intensive care treatment nor were they life-threatening, but they did lead to a longer duration of hospital stay and more frequently to further treatment geriatric or inpatient internal medicine facilities. PMID:27582580

  8. Patient-Centered Mental Health Care for Female Veterans

    PubMed Central

    Kimerling, Rachel; Bastian, Lori A.; Bean-Mayberry, Bevanne A.; Bucossi, Meggan M.; Carney, Diane V.; Goldstein, Karen M.; Phibbs, Ciaran S.; Pomernacki, Alyssa; Sadler, Anne G.; Yano, Elizabeth M.; Frayne, Susan M.

    2016-01-01

    Objective Mental health services for women vary widely across the Veterans Health Administration (VHA) system, without consensus on the need for, or organization of, specialized services for women. Understanding women’s needs and priorities is essential to guide the implementation of patient-centered behavioral health services. Methods In a cross-sectional, multisite survey of female veterans using primary care, potential stakeholders were identified for VHA mental health services by assessing perceived or observed need for mental health services. These stakeholders (N=484) ranked priorities for mental health care among a wide range of possible services. The investigators then quantified the importance of having designated women’s mental health services for each of the mental health services that emerged as key priorities. Results Treatment for depression, pain management, coping with chronic general medical conditions, sleep problems, weight management, and posttraumatic stress disorder (PTSD) emerged as women’s key priorities. Having mental health services specialized for women was rated as extremely important to substantial proportions of women for each of the six prioritized services. Preference for primary care colocation was strongly associated with higher importance ratings for designated women’s mental health services. For specific types of services, race, ethnicity, sexual orientation, PTSD symptoms, and psychiatric comorbidity were also associated with higher importance ratings for designated women’s services. Conclusions Female veterans are a diverse population whose needs and preferences for mental health services vary along demographic and clinical factors. These stakeholder perspectives can help prioritize structural and clinical aspects of designated women’s mental health care in the VHA. PMID:25642611

  9. Attending to Audience: Comparing Optometry Student Talk "with" and "about" Patients

    ERIC Educational Resources Information Center

    Hildebrand, Jenna M.; Spafford, Marlee M.; Schryer, Catherine F.

    2009-01-01

    We explored mediating concepts that affect clinical novices shifting between their talk "with" patients in eye examinations and their talk "about" patients in case presentations (nCPs). In a Canadian optometry teaching clinic, patient "chief concern or request", "illness experience", and "management" utterances were observed in ten eye…

  10. Tobacco use, its influences, triggers, and associated oral lesions among the patients attending a dental institution in rural Maharashtra, India

    PubMed Central

    Kasat, V.; Joshi, M.; Somasundaram, K. V.; Viragi, P.; Dhore, P.; Sahuji, S.

    2012-01-01

    Background: World Health Organization (WHO) predicts that tobacco deaths in India may exceed 1.5 million annually by 2020. Objectives: The aim of this study was to estimate the prevalence of tobacco use, its influences, triggers, and associated oral lesions among the patients of Rural Dental College and Hospital of Loni, Maharashtra. Materials and Methods: A hospital based cross-sectional study was conducted from June - December 2010. All the patients from the outpatient department and with tobacco habits were included in the study. Patients were interviewed through a pre-tested structured questionnaire in relation to their tobacco habits, its influences and triggers. Also clinical examination was carried out to check for any tobacco related oral lesions. For the data analysis, Microsoft Excel and chi-square test was used. Results: The overall prevalence of tobacco use was 16.38%. Smokeless form of tobacco was more prevalent in both males (81.84%) and females (100%). Majority of the patients (males - 68.22%, females- 90.62%) were light tobacco users. About 76.09% males and 31.25% females admitted that they developed the habit due to initial influence of friends. The most common oral mucosal lesion in both the males (42.20%) and females (11.07%) was tobacco hyperkeratosis. Most common trigger for tobacco use was “work related” (69.14%) in males and “after meals” (53.13%) in females. Conclusion: Since the number of tobacco users visiting the dental hospital is reasonably high; dentists can contribute to restrain the hazard through community educational activities such as de-addiction counseling of tobacco users to quit the habit. PMID:24478963

  11. Prevalence of enteric parasites in homosexual patients attending an outpatient clinic.

    PubMed

    Peters, C S; Sable, R; Janda, W M; Chittom, A L; Kocka, F E

    1986-10-01

    A total of 372 pooled stool specimens from 274 homosexual men with diarrhea were submitted for parasitologic examination over a 2.5-year period. Each two-vial pooled specimen set contained portions of stool from 3 consecutive days in Formalin and polyvinyl alcohol. Of the 274 patients, 133 (48.5%) harbored one or more intestinal protozoa, with 161 (43.3%) of the 372 specimens submitted being positive for one or more organisms. The parasites identified included Entamoeba histolytica (71 patients), Giardia lamblia (22 patients), Endolimax nana (106 patients), Entamoeba coli (39 patients), Entamoeba hartmanni (25 patients), Dientamoeba fragilis (3 patients), Iodamoeba bütschlii (2 patients), and Chilomastix mesnili (2 patients). Cryptosporidium sp. (2 patients) and Isospora belli (1 patient) were also detected. Results of this study support the experience of other workers regarding high rates of infection with intestinal parasites in the homosexual population and also indicate that symptomatic individuals belonging to this acquired immunodeficiency syndrome risk group be screened for both common and uncommon intestinal pathogens. PMID:2877006

  12. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola.

    PubMed

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91-52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ (2) = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69-3.21) and 1.42 (95% CI: 0.64-3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  13. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola

    PubMed Central

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ2 = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21) and 1.42 (95% CI: 0.64–3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  14. Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in Hypertensive Patients Attending a Tertiary Hospital in Calabar, Nigeria

    PubMed Central

    Nnenna Adaeze, Nnamani; Uchenna Emeribe, Anthony; Abdullahi Nasiru, Idris; Babayo, Adamu; Uko, Emmanuel K.

    2014-01-01

    Introduction. Several biomedical findings have established the effects of hypertension on haemostasis and roles of blood coagulation products in the clinical course of hypertension. Methods. This cross-sectional study aimed at determining effects of hypertension on prothrombin time (PT) and activated partial thromboplastin time (APTT) in hypertensive patients in comparison with normotensive subjects attending a tertiary hospital in Calabar. Forty-two (42) hypertensive patients and thirty-nine (39) normotensive control subjects were investigated for PT and APTT using Quick one-stage methods. Results. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) correlated positively with APTT (r = 0.3072, r = 0.4988; P < 0.05) in hypertensive patients. DBP, SBP, PT, and APTT were significantly higher in hypertensive patients when compared to normotensive subjects (P < 0.05). DBP correlated negatively with duration of illness (r = −0.3097; P < 0.05) in hypertensive patients and positively with age of normotensive subjects (r = 0.3523; P < 0.05). Conclusion. The results obtained indicated that measurements of PT and APTT may serve as indices for evaluating hemostatic abnormalities in hypertensive patients and guide for antihypertensive therapy. However, to have better understanding of hemostatic activities in hypertension, it is recommended to conduct D-dimer, platelet factors, and protein assays. PMID:25477963

  15. Frequency of paroxysmal nocturnal hemoglobinuria in patients attended in Belém, Pará, Brazil

    PubMed Central

    de Brito Junior, Lacy Cardoso; Cardoso, Maria do Socorro de Oliveira; Rocha, Euzamar Gaby; Anijar, Herika; Cunha, Mariana; Saraiva, João Carlos Pina

    2011-01-01

    Background Paroxysmal nocturnal hemoglobinuria is a hematological disease with complex physiopathology. It is genetically characterized by a somatic mutation in the PIG-A gene (phosphatidylinositol glycan anchor biosynthesis, class A), in which the best known antigens are DAF (decay accelerating factor or CD55) and MIRL (membrane inhibitor of reactive lysis or CD59). Objective To determine the frequency of paroxysmal nocturnal hemoglobinuria in patients attended at the HEMOPA foundation from November 2008 to July 2009. Method Thirty patients, with ages ranging from two to 79 years old and suspected of having paroxysmal nocturnal hemoglobinuria were examined. All patients were immunophenotyped by flow cytometry for the CD5, CD59, CD16 and CD45 antigens. Results Paroxysmal nocturnal hemoglobinuria was identified in nine of the thirty patients investigated. Another 3 cases had inconclusive results with CD59-negative labeling only for neutrophils. The highest frequency of paroxysmal nocturnal hemoglobinuria patients (7/9) and inconclusive cases (2/3) were between 19 years old and 48 years old, with a median of 28 years. Conclusion These results show the importance of flow cytometry to identify cases in which patients are deficient in only one antigen (CD59). PMID:23284241

  16. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs.

    PubMed

    Rayner, Lauren; Hotopf, Matthew; Petkova, Hristina; Matcham, Faith; Simpson, Anna; McCracken, Lance M

    2016-07-01

    This cross-sectional study aimed to determine the prevalence and impact of depression on health care costs in patients with complex chronic pain. The sample included 1204 patients attending a tertiary pain management service for people with chronic disabling pain, unresponsive to medical treatment. As part of routine care, patients completed a web-based questionnaire assessing mental and physical health, functioning, and service use in the preceding 3 months. Depression was assessed using the 9-item Patient Health Questionnaire. Self-report health care utilisation was measured across 4 domains: general practitioner contacts, contacts with secondary/tertiary care doctors, accident and emergency department visits, and days hospitalised. The participation rate was 89%. Seven hundred and thirty-two patients (60.8%; 95% CI 58.0-63.6) met criteria for probable depression, and 407 (33.8%) met the threshold for severe depression. Patients with depression were more likely to be unable to work because of ill health and reported greater work absence, greater pain-related interference with functioning, lower pain acceptance, and more generalised pain. Mean total health care costs per 3-month period were £731 (95% CI £646-£817) for patients with depression, compared with £448 (95% CI £366-£530) for patients without depression. A positive association between severe depression and total health care costs persisted after controlling for key demographic, functional, and clinical covariates using multiple linear regression models. These findings reveal the extent, severity, and impact of depression in patients with chronic pain and make evident a need for action. Effective treatment of depression may improve patient health and functioning and reduce the burden of chronic pain on health care services. PMID:26963849

  17. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs

    PubMed Central

    Rayner, Lauren; Hotopf, Matthew; Petkova, Hristina; Matcham, Faith; Simpson, Anna; McCracken, Lance M.

    2016-01-01

    Abstract This cross-sectional study aimed to determine the prevalence and impact of depression on health care costs in patients with complex chronic pain. The sample included 1204 patients attending a tertiary pain management service for people with chronic disabling pain, unresponsive to medical treatment. As part of routine care, patients completed a web-based questionnaire assessing mental and physical health, functioning, and service use in the preceding 3 months. Depression was assessed using the 9-item Patient Health Questionnaire. Self-report health care utilisation was measured across 4 domains: general practitioner contacts, contacts with secondary/tertiary care doctors, accident and emergency department visits, and days hospitalised. The participation rate was 89%. Seven hundred and thirty-two patients (60.8%; 95% CI 58.0-63.6) met criteria for probable depression, and 407 (33.8%) met the threshold for severe depression. Patients with depression were more likely to be unable to work because of ill health and reported greater work absence, greater pain-related interference with functioning, lower pain acceptance, and more generalised pain. Mean total health care costs per 3-month period were £731 (95% CI £646-£817) for patients with depression, compared with £448 (95% CI £366-£530) for patients without depression. A positive association between severe depression and total health care costs persisted after controlling for key demographic, functional, and clinical covariates using multiple linear regression models. These findings reveal the extent, severity, and impact of depression in patients with chronic pain and make evident a need for action. Effective treatment of depression may improve patient health and functioning and reduce the burden of chronic pain on health care services. PMID:26963849

  18. Personalized disclosure by information-on-demand: attending to patients' needs in the informed consent process.

    PubMed

    Siegal, Gil; Bonnie, Richard J; Appelbaum, Paul S

    2012-01-01

    Obtaining informed consent has typically become a stylized ritual of presenting and signing a form, in which physicians are acting defensively and patients lack control over the content and flow of information. This leaves patients at risk both for being under-informed relative to their decisional needs and of receiving more information than they need or desire. By personalizing the process of seeking and receiving information and allowing patients to specify their desire for information in a prospective manner, we aim to shift genuine control over the informational process to patients. A new paradigm of Information on Demand, such as we suggest, would also enhance legal certainty, achieve greater congruence between the information patients want and the information they receive, and promote more meaningful patient-physician interactions, a desirable outcome that has been difficult to achieve by other means. PMID:22789051

  19. Attending to audience: comparing optometry student talk with and about patients.

    PubMed

    Hildebrand, Jenna M; Spafford, Marlee M; Schryer, Catherine F

    2009-12-01

    We explored mediating concepts that affect clinical novices shifting between their talk with patients in eye examinations and their talk about patients in case presentations (nCPs). In a Canadian optometry teaching clinic, patient 'chief concern or request', 'illness experience', and 'management' utterances were observed in ten eye examinations and nCPs. Twenty-three participants (8 students, 5 instructors, and 10 patients) were observed; 22 were subsequently interviewed. Of 10 nCPs, the 'chief concern or request' was absent in four, the 'illness experience' was incomplete or absent in 9 and 5 of 19 (35.7%) 'management' topics were not discussed with patients. During eye exams, 17 of 31 (54.8%) 'management' discussions with patients were not discussed with instructors during nCPs. Instructional 'scaffolding' (Bruner and Sherwood in Play: its role in development and evolution, p. 280, 1976) appeared limited regarding talk with and about patients. The limited and recontextualized reporting of patient concerns and experiences in nCPs represented lost opportunities to provide and learn patient-centered care. While Goffman's (The presentation of the self in everyday life, p. 114, 1969) 'front stage' performances and Mishler's (The discourse of medicine: dialectics of medical interviews, p. 14, 1984) healthcare 'voices' suggest separate worlds of talk before patients and instructors, we found these worlds were not wholly separate for neophyte speakers. Mediating concepts that influence clinical novices shifting their performances before their audiences, included: (1) pedagogical inconsistencies, (2) incompatible values associated with talk, (3) discordance between patient care and student education, (4) time limitations for teaching, and (5) insufficient instructional 'scaffolding' about talk. PMID:19399636

  20. Comparison of acute non-haemolytic transfusion reactions in female and male patients receiving female or male blood components

    PubMed Central

    Imoto, S; Araki, N; Shimada, E; Saigo, K; Nishimura, K; Nose, Y; Bouike, Y; Hashimoto, M; Mito, H; Okazaki, H

    2007-01-01

    To study the relationship between antibodies detected in patients’ and/or donors’ sera and the clinical features of acute non-haemolytic transfusion reactions (ANHTRs), and to determine any gender-related difference. ANHTRs range from urticaria to transfusion-related acute lung injury (TRALI). Antibodies to human leukocyte antigen (HLA), granulocytes, platelets, and/or plasma proteins are implicated in some of the ANHTRs. A higher antibody positivity is expected for females than for males. A comparative study of ANHTRs for antibody positivity and their clinical features between females and males for both patients and donors is helpful for characterizing ANHTRs including TRALI more clearly, but such studies are few and outdated. Two hundred and twenty-three ANHTR cases reported by 45 hospitals between October 2000 and July 2005 were analysed. The patients and 196 donors of suspect blood products were screened for antibodies to HLA Class I, HLA Class II, granulocytes, and platelets. The patients were also screened for anti-plasma protein antibodies. The types and severity of ANHTR did not differ significantly between female and male patients. The frequency of the anti-HLA antibodies, but not that of the non-HLA antibodies, was significantly higher in females. Non-HLA antibodies were significantly associated with severe reactions in females. All the TRALI cases had predisposing risk factors for acute lung injury, and 60% of the cases showed anti-leucocyte antibodies. Although the anti-HLA antibodies were detected more frequently in females than males, no significant association of ANHTRs including TRALI with gender, not only for patients, but also for donors, could be shown in this study. PMID:18067650

  1. Serological response to syphilis treatment in HIV‐positive and HIV‐negative patients attending sexually transmitted diseases clinics

    PubMed Central

    Ghanem, K G; Erbelding, E J; Wiener, Z S; Rompalo, A M

    2007-01-01

    Background HIV‐positive patients treated for syphilis may be at increased risk for serological failure. Objective To compare follow‐up serologies and serological responses to treatment between HIV‐positive and HIV‐negative patients attending two sexually transmitted disease (STD) clinics. Study design Existing records were reviewed from HIV‐positive patients who were diagnosed and treated for syphilis at the public STD clinics in Baltimore, Maryland, USA, between 1992 and 2000. Results of their serological follow‐up were compared with those of HIV‐negative clinic patients at the time of syphilis treatment. Failure was defined as lack of a fourfold drop in rapid plasma reagin (RPR) titre by 400 days after treatment or a fourfold increased titre between 30 and 400 days. Results Of the 450 HIV‐positive patients with syphilis, 288 (64%) did not have documented follow‐up serologies and 129 (28.5%) met the inclusion criteria; 168 (17%) of 1000 known HIV‐negative patients were similarly eligible. There were 22 failures in the HIV‐positive group and 5 in the HIV‐negative group (p<0.001). The median times to successful serological responses in both groups were 278 (95% confidence interval (CI) 209 to 350) and 126 (95% CI 108 to 157) days, respectively (p<0.001). A multivariate Cox's proportional hazards model showed an increased risk of serological failure among the HIV‐positive patients (hazards ratio 6.0, 95% CI 1.5 to 23.9; p = 0.01). Conclusion HIV‐positive patients treated for syphilis may be at higher risk of serological failure. Despite recommendations for more frequent serological follow‐up, most patients did not have documentation of serological response after standard treatment for syphilis. PMID:16943224

  2. Promoting oral health practice among patients with diabetes attending primary health care clinics

    PubMed Central

    Aljaber, Abeer; Al-Surimi, Khaled

    2015-01-01

    The oral public health program for patients with diabetes was initiated by Saudi Arabia Ministry of Health (MoH) based on international quality standard to control the severity of oral disease in patients with diabetes through improving the accessibility of patients to dental clinics in primary health care centers (PHCC). This program intends to deliver oral health care (OHC) for each patient with diabetes at least one visit every six months. However, we found that more than 90% of patients with diabetes that visited prince Mohammed bin Saud PHCC in Riyadh do not get their regular dental check up every six months. We developed a quality improvement project (QIP) using the quality improvement model to activate MoH oral health program for patients with diabetes visiting prince Mohamed bin Saud PHCC. The aim of our QIP was to increase number of patients with diabetes receiving their regular oral health check up during the PHC visit. The quality team tested two simple improvement ideas. The first idea was having the dentist signature on appointment request. The testing of the first idea led to the second idea, that both physician and dentist should sign the referral form. After running several PDSA cycles to test these interventions ideas, we found the number of patients with diabetes seen in dental clinic had increased dramatically compared with the baseline assessment. We conclude that the idea of signing the referral form by both physician and dentist is a practical and simple strategy to be executed and has a direct impact on the patient clinical flow between clinics. PMID:26734427

  3. Promoting oral health practice among patients with diabetes attending primary health care clinics.

    PubMed

    Aljaber, Abeer; Al-Surimi, Khaled

    2015-01-01

    The oral public health program for patients with diabetes was initiated by Saudi Arabia Ministry of Health (MoH) based on international quality standard to control the severity of oral disease in patients with diabetes through improving the accessibility of patients to dental clinics in primary health care centers (PHCC). This program intends to deliver oral health care (OHC) for each patient with diabetes at least one visit every six months. However, we found that more than 90% of patients with diabetes that visited prince Mohammed bin Saud PHCC in Riyadh do not get their regular dental check up every six months. We developed a quality improvement project (QIP) using the quality improvement model to activate MoH oral health program for patients with diabetes visiting prince Mohamed bin Saud PHCC. The aim of our QIP was to increase number of patients with diabetes receiving their regular oral health check up during the PHC visit. The quality team tested two simple improvement ideas. The first idea was having the dentist signature on appointment request. The testing of the first idea led to the second idea, that both physician and dentist should sign the referral form. After running several PDSA cycles to test these interventions ideas, we found the number of patients with diabetes seen in dental clinic had increased dramatically compared with the baseline assessment. We conclude that the idea of signing the referral form by both physician and dentist is a practical and simple strategy to be executed and has a direct impact on the patient clinical flow between clinics. PMID:26734427

  4. Prevalence and Specificity of RBC Alloantibodies in Indian Patients Attending a Tertiary Care Hospital.

    PubMed

    Zaman, Shamsuz; Chaurasia, Rahul; Chatterjee, Kabita; Thapliyal, Rakesh Mohan

    2014-01-01

    Background. Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. Data about alloimmunization rate in general patient population is scarce especially from resource limited countries. We undertook this study to determine prevalence and specificity of RBC alloantibodies in patients admitted in various clinical specialties at a tertiary care hospital in North India. Methods. Antibody screening was carried out in 11,235 patients on automated QWALYS 3 platform (Diagast, Loos, France). Antibody identification was carried out with an 11-cell identification panel (ID-Diapanel, Diamed GmbH, Switzerland). Results. The overall incidence of RBC alloimmunization in transfused patients was 1.4% (157/11235), with anti-E being the most common specificity (36.3%), followed by anti-D (16%), anti-c (6.4%), anti-c + E (6.4%), anti-C + D (5.1%), and anti-K (4.5%). The highest incidence of alloimmunization was observed in hematology/oncology patients (1.9%), whereas in other specialties the range was 0.7-1%. Conclusion. As alloimmunization complicates the transfusion outcomes, authors recommend pretransfusion antibody screening and issue of Rh and Kell matched blood to patients who warrant high transfusion requirements in future. PMID:25386192

  5. The Effect of Attending Good Psychiatric Management (GPM) Workshops on Attitudes Toward Patients with Borderline Personality Disorder

    PubMed Central

    Keuroghlian, Alex S.; Palmer, Brian A.; Choi-Kain, Lois W.; Borba, Christina P. C.; Links, Paul S.; Gunderson, John G.

    2015-01-01

    The effect that attending a 1-day workshop on good psychiatric management (GPM) had on attitudes about borderline personality disorder (BPD) was assessed among 297 clinicians. Change was recorded by comparing before and after scores on a 9-item survey previously developed to assess the effects of workshops on Systems Training for Emotional Predictability and Problem Solving (STEPPS). Participants reported decreased inclination to avoid borderline patients, dislike of borderline patients, and belief that BPD’s prognosis is hopeless, as well as increased feeling of competence, belief that borderline patients have low self-esteem, feeling of being able to make a positive difference, and belief that effective psychotherapies exist. Less clinical experience was related to an increased feeling of competence and belief that borderline patients have low self-esteem. These findings were compared to those from the STEPPS workshop. This assessment demonstrates GPM’s potential for training clinicians to meet population-wide needs related to borderline personality disorder. PMID:26111249

  6. Health Related Quality of Life May Increase when Patients with a Stoma Attend Patient Education – A Case-Control Study

    PubMed Central

    Danielsen, Anne Kjaergaard; Rosenberg, Jacob

    2014-01-01

    Introduction Adaptation to living with a stoma is complex, and studies have shown that stoma creation has a great impact on patients' health related quality of life. The objective was to explore the effect of a structured patient education program on health related quality of life. Therefore, we implemented interventions aimed at increasing health related quality of life during and after hospital admission. Materials and Methods We designed a case/control study aimed at adult patients admitted to the surgical ward for stoma creation, irrespective of type of stoma or reason for creation of stoma. We included 50 patients in the study. Health related quality of life was measured before hospital discharge, three months and six months after stoma creation. The program included educational interventions involving lay-teachers, alongside health professional teachers. Results We found a significant rise in health related quality of life in the intervention group (P<0.001) and no significant change in the control group (P = 0.144). However, we found no significant differences when comparing between groups at 3 and 6 months (p = 0.12 and p =  0.63, respective). Additionally, there were differences in scores in health related quality of life baseline (p = 0.045) with lower scores in the intervention group compared with the intervention group. However, there were no significant differences in the demographic variables at baseline Conclusions Educational activities aimed at increase in knowledge and focusing on patients' psychosocial needs may lead to a rise in patients' health related quality of life. When patients with a stoma attend a structured patient education program it is possible to improve their health related quality of life compared with patients with a stoma, who do not attend the program. Trial Registration ClinicalTrials.gov NCT01154725 PMID:24609004

  7. Quality of life and disease understanding: impact of attending a patient-centered cancer symposium

    PubMed Central

    Padrnos, Leslie; Dueck, Amylou C; Scherber, Robyn; Glassley, Pamela; Stigge, Rachel; Northfelt, Donald; Mikhael, Joseph; Aguirre, Annette; Bennett, Robert M; Mesa, Ruben A

    2015-01-01

    To evaluate the impact of a patient-centered symposium as an educational intervention on a broad population of cancer patients. We developed a comprehensive patient symposium. Through voluntary questionnaires, we studied the impact of this cancer symposium on quality of life, cancer-specific knowledge, and symptom management among cancer patients. Symposium attendees were provided surveys prior to and 3 months following the educational intervention. Surveys included (1) EORTC-QLQ-C30; (2) disease understanding tool developed for this conference; (3) validated disease-specific questionnaires. Changes over time were assessed using McNemar's tests and paired t-tests for categorical and continuous variables, respectively. A total of 158 attendees completed the pre-convention survey. Most respondents reported at least “quite a bit” of understanding regarding treatment options, screening modalities, symptomatology, and cancer-related side effects. Attendees endorsed the least understanding of disease-related stress, risk factors, fatigue management, and legal issues related to disease/treatment. At 3 months, there was improvement in understanding (12 of 14 areas of self-reported knowledge especially regarding nutrition, and stress/fatigue management). However, no significant change was seen in QLQ-C30 functioning, fatigue, pain, or insomnia. A patient symposium, as an educational intervention improves a solid knowledge base amongst attendees regarding their disease, increases knowledge in symptom management, but may be insufficient to impact QoL as a single intervention. PMID:25641947

  8. Demographic characteristic and analysis of pulmonary paragonimiasis in patients attending RIMS, Manipur

    PubMed Central

    Sunanda, Haorongbam; Shivalingaiah, Bhavya; Paley, Tamar; Asoka, Wangkheimayum

    2016-01-01

    Background: Human infection by the lung fluke Paragonimus westermani is widely distributed in Africa, Asia, and South America. Transmission of the parasite to humans primarily occurs through the consumption of raw or undercooked crabs. Clinical features of recently diagnosed pulmonary Paragonimiasis show that patients present with a variety of clinical and radiological findings, frequently mimics tuberculosis and lung cancer. Methods: Here in this study, we report a cross-sectional study of pulmonary paragonimiasis in our institute over a period of two year. Results: it was observed that out of eleven cases, prevalence of paragonimiasis was almost equal among both the genders, with a mean age of 38.1 ± 16.96, affecting people from hills. Three patients were erroneously treated with antitubercular drugs without any relief. The association with eosinophilia in the peripheral blood and tissue[16] was seen in all the study subjects and majority patients had pleural fluid eosinophilia. Patients were diagnosed by serological test, Paragonimus ova in Sputum smear and Pleural fluid. All study subjects had excellent clinical responses to praziquantel given at dose of 25 mg/kg given orally 3 times daily for 3 consecutive days. Conclusions: There is a need to generate awareness among the clinicians and public regarding Paragonimiasis and to consider it in differential diagnosis of TB and carcinoma lung. Physicians should consider the possibility of paragonimiasis among patients who present with chest complaints with eosinophilia from the endemic regions. PMID:27051099

  9. Frequency and risk factors associated with dry eye in patients attending a tertiary care ophthalmology center in Mexico City

    PubMed Central

    Martinez, Jaime D; Galor, Anat; Ramos-Betancourt, Nallely; Lisker-Cervantes, Andrés; Beltrán, Francisco; Ozorno-Zárate, Jorge; Sánchez-Huerta, Valeria; Torres-Vera, Marco-Antonio; Hernández-Quintela, Everardo

    2016-01-01

    Purpose The purpose of this study was to ascertain the frequency and risk factors of dry eye (DE) among patients attending a tertiary care ophthalmology center in Mexico. Methods Approximately 338 consecutive new patients attending a tertiary care ophthalmology center in Mexico City underwent an ocular surface examination, which included tear film break-up time, fluorescein corneal staining, Schirmer’s test, and evaluation of meibum quality. Symptoms of DE were evaluated by the Ocular Surface Disease Index and Dry Eye Questionnaire-5. Information on demographics, exposures, past medical and ocular history, and medications was also collected. Results The frequency of severe DE symptoms was found to be 43% based on the Ocular Surface Disease Index and 30% based on Dry Eye Questionnaire-5. Risk factors significantly associated with increased DE symptoms included dry mouth and gastrointestinal ulcer medications. With regard to signs, aqueous tear deficiency was a less-frequent finding (22%) in our population than evaporative deficiency (94%). Risk factors associated with aqueous tear deficiency were dry mouth and diuretic use. No risk factors were associated with evaporative deficiency. Risk factors associated with meibomian gland dysfunction included old age, male sex, arthritis, and use of an antihypertensive. The only risk factor associated with corneal staining was dry mouth. Conclusion This is the first study to demonstrate the frequency of symptomatic and clinical DE in a tertiary care ophthalmology center in Mexico. The frequency of DE ranged from 30% using a symptomatic definition to 94% using objective measures. Different risk factors were found for different aspects of DE, suggesting differing underlying pathophysiologies behind different DE subtypes. PMID:27499613

  10. Review of emergency thoracotomy for chest injuries in patients attending a UK Accident and Emergency department.

    PubMed

    Bleetman, A; Kasem, H; Crawford, R

    1996-03-01

    Over a two and a half year period, 25 patients presenting to the Glasgow Royal Infirmary underwent emergency thoracotomy for suspected severe chest injuries. Eighteen (72 per cent) were performed in the Accident and Emergency (A&E) department and seven (28 per cent) in a fully equipped operating theatre after resuscitation. There were 23 men and 2 women. Twenty-three (92 per cent) had been stabbed, one (4 per cent) had been shot and one (4 per cent) had sustained a blunt injury in a road traffic accident. Eight (32 per cent) patients survived. All survivors had been stabbed and seven were well enough to undergo thoracotomy in theatre. Only one (5.6 per cent) of the patients operated upon in the A&E department survived to discharge, although three (16.8 per cent) survived the initial procedure. Three of four patients survived, in whom the diagnosis of cardiac tamponade was initially missed. Thirteen (76.5 per cent) of the 17 who did not survive had no vital signs on admission. Outcomes may be improved if appropriately trained hospital staff are immediately available and prehospital delays are minimized so that patients arrive sooner with signs of life still present. Ambulance paramedic interventions have little to offer these patients and may worsen the prognosis if they result in delayed transport to hospital. The emphasis placed on diagnosis and treatment of cardiac tamponade in Advanced Trauma Life Support programmes is appropriate and all staff involved in these cases should undergo this type of training. PMID:8730388

  11. "Empathy" and "Sympathy" in Action: Attending to Patients' Troubles in Finnish Homeopathic and General Practice Consultations

    ERIC Educational Resources Information Center

    Ruusuvuori, Johanna

    2005-01-01

    This paper analyzes "empathy" and "sympathy" as situated practices, sequential processes that are coconstructed by the participants in the situation. The data consists of 228 sequences of patients' descriptions of their problematic experiences and professionals' responses to them in videorecorded general practice and homeopathic consultations. One…

  12. Improving physician's adherence to completing vaccination schedules for patients with type 2 diabetes attending non-communicable diseases clinics in West Bay Health Center, Qatar

    PubMed Central

    Tawfik, Hassan; Bashwar, Zelaikha; Al-Ali, Amal; Salem, Mohamed; Abdelbagi, Isameldin

    2015-01-01

    Incomplete vaccination for patients with type 2 diabetes attending non-communicable diseases (NCD) clinics is an issue that could affect patient's health and wellness negatively and puts patients at high risk of serious diseases. We aimed to improve physicians adherence to complete vaccination schedule for patients with type 2 diabetes attending NCD clinics in west bay health center according to American Diabetes Association (ADA) recommendation by 25% by January 2015. In the pre-intervention phase: the quality improvement team designed a checklist to collect the percentage of physician's adherence of prescription of the recommended vaccination for patients with type 2 diabetes. The percentage of complete vaccination in patients with diabetes attending NCD clinic in West Bay Health Center was 20% . In the intervention phase the intervention was in the form of: the creation a vaccination form and attached to the (NCD) progress note; to distribute and remind the physicians about the ADA guidelines vaccination recommendations; a summary of the vaccination schedule developed and attached to (NCD) form; development of vaccination reminder posters and posters in the waiting area, nurse station, and physician clinics and education and orientation sessions for NCD clinic staff. In the post-intervention phase the average percentage of complete vaccination in patients with diabetes attending NCD clinic in West Bay Health Center increased to 69%. PMID:26732463

  13. Sociodemographic and Clinical Characteristics of Patients attending Psychotherapy in a Tertiary Care Hospital in Oman

    PubMed Central

    Al-Sharbati, Zena; Hallas, Claire; Al-Zadjali, Hazar; Al-Sharbati, Marwan

    2012-01-01

    Objectives: There is significant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani health care system. This study aimed to investigate the sociodemographic and clinical characteristics of attendees at a psychotherapy clinic at a tertiary care hospital. Methods: An analysis was carried out of 133 new referrals to the Psychotherapy Service at Sultan Qaboos University Hospital, a tertiary care hospital. Results: The majority of referrals were females (59%), aged 18–34 years, employed (38%), had ≤12 years of formal education (51%), and were single (54%). A total of 43% were treated for anxiety disorders (including obsessive compulsive disorder), while 22% were treated for depression. A total of 65% were prescribed psychotropic medications. The utilisation of the Psychotherapy Service and its user characteristics are discussed within the context of a culturally diverse Omani community which has unique personal belief systems such as in supernatural powers (Jinn), contemptuous envy (Hassad), evil eye (Ain) and sorcery (Sihr) which are often used to explain the aetiology of mental illness and influence personal decisions on utilising medical and psychological treatments. Conclusion: Despite the low number of referrals to the Psychotherapy Service, there is reason to believe that psychotherapy would be an essential tool to come to grips with the increasing number of mental disorders in Oman. PMID:22375255

  14. Viral Respiratory Tract Infections in Adult Patients Attending Outpatient and Emergency Departments, Taiwan, 2012–2013

    PubMed Central

    Shih, Hsin-I; Wang, Hsuan-Chen; Su, Ih-Jen; Hsu, Hsiang-Chin; Wang, Jen-Ren; Sun, Hsiao Fang Sunny; Chou, Chien-Hsuan; Ko, Wen-Chien; Hsieh, Ming-I; Wu, Chi-Jung

    2015-01-01

    Abstract Viral etiologies of respiratory tract infections (RTIs) have been less studied in adult than in pediatric populations. Furthermore, the ability of PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) to detect enteroviruses and rhinoviruses in respiratory samples has not been well evaluated. We sought to use PCR/ESI-MS to comprehensively investigate the viral epidemiology of adult RTIs, including testing for rhinoviruses and enteroviruses. Nasopharyngeal or throat swabs from 267 adults with acute RTIs (212 upper RTIs and 55 lower RTIs) who visited a local clinic or the outpatient or emergency departments of a medical center in Taiwan between October 2012 and June 2013 were tested for respiratory viruses by both virus isolation and PCR/ESI-MS. Throat swabs from 15 patients with bacterial infections and 27 individuals without active infections were included as control samples. Respiratory viruses were found in 23.6%, 47.2%, and 47.9% of the 267 cases by virus isolation, PCR/ESI-MS, and both methods, respectively. When both methods were used, the influenza A virus (24.3%) and rhinoviruses (9.4%) were the most frequently identified viruses, whereas human coronaviruses, human metapneumovirus (hMPV), enteroviruses, adenoviruses, respiratory syncytial virus, and parainfluenza viruses were identified in small proportions of cases (<5% of cases for each type of virus). Coinfection was observed in 4.1% of cases. In the control group, only 1 (2.4%) sample tested positive for a respiratory virus by PCR/ESI-MS. Patients who were undergoing steroid treatment, had an active malignancy, or suffered from chronic obstructive pulmonary disease (COPD) were at risk for rhinovirus, hMPV, or parainfluenza infections, respectively. Overall, immunocompromised patients, patients with COPD, and patients receiving dialysis were at risk for noninfluenza respiratory virus infection. Rhinoviruses (12.7%), influenza A virus (10.9%), and parainfluenza viruses (7.3%) were the most

  15. Prevalence of Dermatophytic Infection and the Spectrum of Dermatophytes in Patients Attending a Tertiary Hospital in Addis Ababa, Ethiopia

    PubMed Central

    Teklebirhan, Gebreabiezgi; Bitew, Adane

    2015-01-01

    Background. Dermatophytosis is common worldwide and continues to increase. Objective. This study was undertaken to determine the prevalence of dermatophytosis and the spectrum of ringworm fungi in patients attending a tertiary hospital. Methods. Samples were collected from 305 patients. A portion of each sample was examined microscopically and the remaining portion of each sample was cultured onto plates of Sabouraud's dextrose agar containing chloramphenicol with and without cycloheximide. Dermatophyte isolates were identified by studying macroscopic and microscopic characteristics of their colonies. Result. Of 305 samples, fungi were detected in 166 (54.4%) by KOH of which 95 were dermatophytes while 242 (79.4%) samples were culture positive of which 130 isolates were dermatophytes. Among dermatophyte isolates T. violaceum was the most common (37.7%) cause of infection. Tinea unguium was the predominant clinical manifestation accounting for 51.1% of the cases. Patients with age group 25–44 and 45–64 years were more affected. T. violaceum was the most common pathogen in tinea unguium and tinea capitis, whereas T. mentagrophytes was the most common pathogen in tinea pedis. Conclusion. Further intensive epidemiological studies of ring worm fungus induced dermatophytosis which have public health significance are needed. PMID:26448763

  16. Prevalence of Dermatophytic Infection and the Spectrum of Dermatophytes in Patients Attending a Tertiary Hospital in Addis Ababa, Ethiopia.

    PubMed

    Teklebirhan, Gebreabiezgi; Bitew, Adane

    2015-01-01

    Background. Dermatophytosis is common worldwide and continues to increase. Objective. This study was undertaken to determine the prevalence of dermatophytosis and the spectrum of ringworm fungi in patients attending a tertiary hospital. Methods. Samples were collected from 305 patients. A portion of each sample was examined microscopically and the remaining portion of each sample was cultured onto plates of Sabouraud's dextrose agar containing chloramphenicol with and without cycloheximide. Dermatophyte isolates were identified by studying macroscopic and microscopic characteristics of their colonies. Result. Of 305 samples, fungi were detected in 166 (54.4%) by KOH of which 95 were dermatophytes while 242 (79.4%) samples were culture positive of which 130 isolates were dermatophytes. Among dermatophyte isolates T. violaceum was the most common (37.7%) cause of infection. Tinea unguium was the predominant clinical manifestation accounting for 51.1% of the cases. Patients with age group 25-44 and 45-64 years were more affected. T. violaceum was the most common pathogen in tinea unguium and tinea capitis, whereas T. mentagrophytes was the most common pathogen in tinea pedis. Conclusion. Further intensive epidemiological studies of ring worm fungus induced dermatophytosis which have public health significance are needed. PMID:26448763

  17. Dermatophytes and other associated fungi in patients attending to some hospitals in Egypt

    PubMed Central

    Abd Elmegeed, Al Shimaa M.; Ouf, S.A.; Moussa, Tarek A.A.; Eltahlawi, S.M.R.

    2015-01-01

    Dermatophytes are keratinophilic fungi that infect keratinized tissues causing diseases known as dermatophytoses. Dermatophytes are classified in three genera, Epidermophyton, Microsporum, and Trichophyton. This investigation was performed to study the prevalence of dermatomycosis among 640 patients being evaluated at the dermatology clinics at Kasr elainy, El-Husein and Said Galal hospitals in Cairo and Giza between January 2005 and December 2006. The patients were checked for various diseases. Tinea capitis was the most common clinical disease followed by tinea pedis and tinea corporis. Tinea cruris and tinea unguium were the least in occurrence. Tinea versicolor also was detected. The most susceptible persons were children below 10 years followed by those aged 31–40 years. Unicellular yeast was the most common etiological agent and T. tonsuranswas the second most frequent causative agent followed by M. canis. PMID:26413063

  18. Reflecting on Research: Self- Monitoring of Blood Glucose among Diabetes Patients Attending Government Health Clinics.

    PubMed

    Mastura, I

    2008-01-01

    This article described the author's reflection on conducting research in primary care. Certainly hand-on experience will give a better learning experience for a person to explore further in research and research training will help too. Conducting a collaborative research with other institutions also help in better research outcome. Research capacity building is important as most patients are seen in primary care. PMID:25606148

  19. Improving feedback from outpatient medical appointments attended by escorted psychiatric patients in the North London Forensic Service

    PubMed Central

    McCurdy, Kathleen; Croxford, Anna

    2015-01-01

    It is well established that patients with mental illness are known to have a high level of morbidity and mortality compared to the general population. This is particularly prominent in long-stay psychiatric patients, such as those in secure settings. The Royal College of Psychiatrists recommends that psychiatrists should promote the physical health of their patients and liaise with other specialties. However, there is evidence that communication between psychiatry and other specialties is poor. A survey was carried out at the North London Forensic Service in June 2014. This looked at the views of clinical staff about the frequency and quality of feedback obtained when inpatients attend outpatient hospital appointments at local general hospitals. This survey highlighted the general perception among staff that feedback is poor, with 68.43% of respondents saying that they were “very unsatisfied” or “unsatisfied” with the level and quality of feedback. Clinical staff felt that many patients who attended hospital outpatient appointments, even when escorted by staff, returned with little or no feedback. This was confirmed by a baseline audit across 3 wards showing that details of the appointment (date, time, hospital, and specialty) were only documented in 54.5% of cases and the content of the appointment documented in even fewer cases. A form was designed by junior doctors that provided a simple framework of 6 questions to be answered at the outpatient clinic about the problem, diagnosis, and further actions needed. This was introduced and its impact assessed with a 3-month and 6-month audit of electronic notes, as well as a follow-up survey after 6 months. The audit showed significant improvement in the quality of feedback about the appointment at both the 3-month and 6-month point. The follow-up survey showed that 70% of respondents were aware of the form and 100% of those who were aware of the form had used it at least once and found it helpful. The general

  20. The consequences of task delegation for the process of care: Female patients seem to benefit more.

    PubMed

    Noordman, Janneke; van Dulmen, Sandra

    2016-01-01

    The shift of tasks from primary care physicians to practice nurses and the continuing incease in the numbers of women involved in medical care may have consequences for the provision of health care and communication. The aim of the present study was to examine potential differences in female practice nurses' application of communication skills, practice guidelines, and motivational interviewing skills during consultations with female and male patients. Nineteen female practice nurses and their patients (n = 181) agreed to have their consultations videotaped (during 2010-2011). The videotaped consultations were rated using two validated instruments: the Maas-Global (to assess generic communication skills and practice guidelines) and the Behaviour Change Counselling Index (to assess motivational interviewing skills). Multilevel linear and logistic regression analyses were performed. Female practice nurses provided significantly more comprehensive information during consultations with female patients (p = .03) and talked more about management with male patients (p = .04). Furthermore, nurses applied motivational interviewing skills more clearly during consultations with female than with male patients (p < .01). The shift in tasks from primary care physicians toward practice nurses may have implications for clinical and patient outcomes as patients will no longer be counseled by male professionals. Conceivably, female patients are motivated more by nurses to change their behavior, while male patients receive more concrete management information or advice. PMID:26325441

  1. Prevalence of intestinal parasites among HIV/AIDS patients attending Infectious Disease Hospital Kano, Nigeria

    PubMed Central

    Jegede, Ebenezer Feyisayo; Oyeyi, Esther Tinuade Ibijoke; Bichi, ArmaYau Hamisu; Mbah, Henry Akwen; Torpey, Kwasi

    2014-01-01

    Introduction Intestinal parasitic infection has been a major source of morbidity in tropical countries especially among HIV patients. The aim of this study was to determine prevalence of intestinal parasites and its association with immunological status and risk factors among HIV infected patients in Kano, Nigeria. Methods 105 HIV+ subjects and 50 HIV- controls were recruited into the studies from June to December 2010. Clinical information was collected using a questionnaire. Single stool and venous blood samples were collected from each subject. Stool examination and CD4+ count were performed. Results Prevalence of intestinal parasites was 11.4% and 6% among the HIV+ and control subjects respectively with no statistically significant difference (p = 0.389). Specifically, the following intestinal parasites were isolated from HIV+ subjects: Entamoebahistolytica (5.7%), hookworm (3.8%), Entamoeba coli (1%), Blastocystishominis (1%). Only Entamoebahistolytica was isolated among the control subjects. The mean CD4+ count of HIV+ and control subjects was 287 cells/ul and 691 cells/µlrespectively while the median was 279(Q1-120, Q3-384) cell/µl and 691(Q1-466, Q3-852) cell/µlrespectively with statistically significant difference (P= 0.021). Diarrhea and the absence of anti-parasitic therapy seem to be important risk factors associated with the occurrence of intestinal parasites among HIV+ subjects. A higher prevalence (14.5%) of intestinal parasites was observed in subject with CD4+ count 350cell/µl. Conclusion Routine examination for intestinal parasites should be carried out for better management of HIV/AIDS patients. PMID:25328591

  2. Intestinal metaplasia at the squamocolumnar junction in patients attending for diagnostic gastroscopy

    PubMed Central

    Trudgill, N; Suvarna, S; Kapur, K; Riley, S

    1997-01-01

    Background—The incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing rapidly. Barrett's oesophagus is the major risk factor. Intestinal metaplasia at the squamocolumnar junction in the absence of Barrett's oesophagus is common but its relation to adenocarcinoma and gastro-oesophageal reflux disease is unclear. 
Aims—To study the prevalence and clinical, endoscopic, and histological associations of intestinal metaplasia at the squamocolumnar junction. 
Methods—Biopsy specimens were taken from 120 randomly selected patients undergoing routine diagnostic endoscopy. Eight biopsy specimens, taken from above and below the squamocolumnar junction, gastric fundus, and gastric antrum, were stained with haematoxylin/eosin, alcian blue/periodic acid-Schiff, and Gimenez, and graded independently by one pathologist. 
Results—Intestinal metaplasia at the squamocolumnar junction was found in 21 patients (18%). Metaplasia was associated with increasing age (p<0.01) and antral intestinal metaplasia (p=0.04). Logistic regression analysis revealed that age was the only independent predictor (p<0.01). There was no association with symptomatic, endoscopic, or histological markers of gastro-oesophageal reflux disease. 
Conclusions—Intestinal metaplasia at the squamocolumnar junction is a common finding. It is associated with increasing age but not gastro-oesophageal reflux disease. 

 Keywords: intestinal metaplasia; Barrett's oesophagus; gastro-oesophageal reflux disease; oesophagus; gastric cardia; adenocarcinoma PMID:9414961

  3. [Refractory hypertention in a female patient with renal failure].

    PubMed

    Zuccalà, A; Losinno, F; Fiorenza, S; Lifrieri, F; Rapanà, R

    2005-01-01

    We report one sixty-seven years-old female who presented with hypertension refractory to antihypertensive drugs. She had an elevated BP for approximately 15 years. In the last 8-10 months her hypertension had become difficult to control. Her BP ranged between 180/100 mmHg and 220/1220 mmHg on atenolol 100 mg once daily, methyldopa 500 mg three times daily, furosemide 25 mg twice daily, doxazosine 4 mg twice daily. When she was referred to our unit serum creatinine was 2.3 mg/dL and she had a mild proteinuria (70 mg/dL) without microematuria. Ultrasonography showed a left kidney size in the low-normal range (LD 11 cm) and a small right kidney (LD 9 cm). Renal angiography showed a severe, ostial stenosis of the left renal artery and a total thrombosis of the right renal artery with a blood supply to the right kidney provided by collateral channels. An ACE-I was added to the therapy but a sharp increase in serum creatinina (up to 6.4 mg/dL) prompted us to withdraw the drug. She underwent a renal angioplasty on the left side and a Palmaz stent was placed. The control angiography showed a good anatomical result. Three months after the manoeuvre the patient was again referred to our unit with headache, nausea vomiting and hyper-tension refractory to amlodipine 10 mg/day, doxazosine 4 mg twice a a day, atenolol 50 mg/day, furosemide 50 mg/day. A doppler ultrasonography and a magnetic resonance angiogram showed no restenosis on the treated artery. An ACE-I was again administered and BP on this drug was 145/90 mmHg after one month and 130/85 after three months. Headache, nausea and vomiting disappeared. Serum creatinina kept unchanged (2.2 mg/dL). Comment. In this case the benefit of angioplasty on blood pressure control was indirect. Apparently the manoeuvre showed no effect on blood pressure, but the angioplasty allowed us to use of an ACE-Inhibitor, without any negative effect on renal function, and thus to adequately control blood pressure. PMID:16342054

  4. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND... and accompanied by such medical, nursing, or other attendants as may be necessary to protect the... requiring the services of attendants shall be accompanied by at least one female attendant. Medical...

  5. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND... and accompanied by such medical, nursing, or other attendants as may be necessary to protect the... requiring the services of attendants shall be accompanied by at least one female attendant. Medical...

  6. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND... and accompanied by such medical, nursing, or other attendants as may be necessary to protect the... requiring the services of attendants shall be accompanied by at least one female attendant. Medical...

  7. The Horse Boy--attending to the stories our patients tell us.

    PubMed

    Karlinsky, Harry

    2013-07-01

    In the summer of 2007, Rupert Isaacson and Kirsten Neff set off to Mongolia on an extraordinary journey to heal their 7-year old autistic son. Their story was captured on film by a small crew, and both the resulting documentary, The Horse Boy, and the associated book have reached a wide audience. For those involved in psychiatric education, the film represents a valuable opportunity to explore a range of relevant clinical and ethical issues with their learners, including an introduction to the world of complementary and alternative medicine and the emerging discipline of narrative medicine. Perhaps most importantly, The Horse Boy is an impetus for health professionals to consider their own responsibilities when determined patients in their care undertake such remarkable quests to heal themselves or their loved ones. PMID:23820912

  8. Clinical and epidemiological profile of leprosy patients attended at Ceará, 2007-2011*

    PubMed Central

    Queirós, Maria Iranilda; Ramos Júnior, Alberto Novaes; Alencar, Carlos Henrique Morais; Monteiro, Lorena Dias; Sena, Amanda Lima; Barbosa, Jaqueline Caracas

    2016-01-01

    Background Leprosy is an infectious chronic condition associated with potentially serious physical, social and psychological impacts. Objectives To characterize the clinical and epidemiological profile of leprosy patients treated from 2007 to 2011 in the University Hospital of Ceará, Northeastern Brazil. Methods This is a retrospective and descriptive study. The study population consisted of residents in the state of Ceará treated in a dermatology clinic between 2007-2011. Clinical and epidemiological data analyzed were obtained from medical records and from the database of national Information System for Notifiable Diseases. Results 475 cases were analyzed, mostly women (51.8%), aged 45-59 years (35.0%) - mean of 45.2 years at diagnosis - with 6.3% of children under 15 , with low education (73.7%), white color (68.8%), residency in the city of Fortaleza (82.3%), and no defined work occupation (59.6%). At diagnosis, most patients were multibacillary (MB) (65.5%), had borderline clinical form (48.0%), and 22.7% had physical disability (8.0% with grade 2), predominantly in MB cases (p <0.001). We observe worsening of disability in 5.1% of cases post-MDT. The proportion of cases with reactional episodes was 42.7%, mainly during MDT (51.2%). Conclusion This is the first study conducted in this hospital context, revealing late diagnosis, high burden of disease, hidden endemicity, and high social vulnerability in the state of Ceará. This study reinforces the need to strengthen health care network for timely diagnosis and treatment, aiming at longitudinality of assistance. PMID:27438198

  9. Periodontal disease status and associated risk factors in patients attending a Dental Teaching Hospital in Rawalpindi, Pakistan

    PubMed Central

    Bokhari, Syed Akhtar Hussain; Suhail, Agha Mohammad; Malik, Abdul Razzaq; Imran, Mian Farrukh

    2015-01-01

    Background: Investigators have identified an association of socio-demographic and medical factors with periodontal risk. This study observed status and association of periodontal disease and associated risk factors/indictors. Materials and Methods: All patients attending a dental teaching hospital were interviewed for socio-demographic and medical information through a structured questionnaire. Participants were examined for periodontal status using the community periodontal index (CPI), by a single examiner during September to November 2012. An association of age, gender, smoking habit, systemic conditions, and oral hygiene measures with periodontal status ([periodontitis CPI score ≥3]/nonperiodontitis [CPI score ≤2]) was analyzed by applying Chi-square test and forward selection stepwise regression analysis. Results: One thousand nine hundred and eighteen patients were examined during the study period. The findings revealed that 63.5% of the subjects had CPI score ≤2 (nonperiodontitis), while 34.5% were found with CPI score ≥3 (periodontitis). Age, gender, occupation, smoking, diabetes, arthritis, cardiovascular disease, kidney disease, stress, medications, and oral hygiene habits of using tooth powder or tooth brushing were significantly (P ≤ 0.037) associated with periodontal status. Regression analysis showed a significant association of age, occupation, and smoking with periodontitis. Conclusion: This study observed prevalence of periodontitis in one-fourth of study sample. The study confirmed various socio-demographic risk factors/indictors associated with increased risk of periodontitis. PMID:26941520

  10. Prevalence of HBV Infection and Knowledge of Hepatitis B Among Patients Attending Primary Care Clinics in Poland.

    PubMed

    Ganczak, Maria; Dmytrzyk-Daniłów, Gabriela; Korzeń, Marcin; Drozd-Dąbrowska, Marzena; Szych, Zbigniew

    2016-06-01

    It is well known that community awareness of hepatitis B (HB) can lead to vaccination and testing. The study objectives were to assess the prevalence of HBV infection and knowledge of HB among adult patients attending randomly selected primary care clinics. A cross-sectional sero-survey was conducted in March 2013 in the Zgorzelec region, Poland, with the use of an investigator-developed questionnaire containing 22 questions regarding HB knowledge. Serum samples were assayed for anti-HBc total and anti-HBs with enzyme immunoassay. The prevalence of anti-HBc total among 410 participants (median age 56 years) was 10.3 % (95 % CI 7.6-13.8 %), nobody was aware of an infection. The main sources of HB knowledge were the media and medical staff. The mean knowledge score was 14.8 ± 4.9; 76.7 % of the respondents had scores >50 %. Particular gaps were detected relating to knowledge of unprotected sexual intercourse and MTCT; 45.6 % patients were not aware of the potential asymptomatic course of HBV infection, 41.2 % about chronic HB treatment. A patient's low educational level was negatively associated with a high knowledge level; the willingness for further education on HB and HBV vaccination in the past were independently associated with good knowledge. In conclusion, the HBV infection remains a public health threat in Poland, since the prevalence of infection markers in asymptomatic adult patients was high. Knowledge gaps call for awareness campaigns which may increase testing and diagnosis, audiences representing lower education level should be targeted first. Knowledge on HB might serve as an effective tool in decision making regarding vaccination. PMID:26699149

  11. Profiles of medicinal cannabis patients attending compassion centers in rhode island.

    PubMed

    Zaller, Nickolas; Topletz, Ariel; Frater, Susan; Yates, Gail; Lally, Michelle

    2015-01-01

    Little is understood regarding medicinal marijuana dispensary users. We sought to characterize socio-demographics and reasons for medicinal marijuana use among medical cannabis dispensary patients in Rhode Island. Participants (n=200) were recruited from one of two Compassion Centers in Rhode Island and asked to participate in a short survey, which included assessment of pain interference using the Brief Pain Inventory (BPI). The majority of participants were male (73%), Caucasian (80%), college educated (68%), and had health insurance (89%). The most common reason for medicinal marijuana use was determined to be chronic pain management. Participants were more likely to have BPI pain interference scores of > 5 if they were older (OR: 1.36, 95% CI: 1.04-1.78) or reported using cannabis as a substitute for prescription medications (OR: 2.47, 95% CI: 1.23-4.95), and were less likely to have interference scores of >5 if they had higher income levels (OR: 0.53, 95% CI: 0.40-0.70) or reported having ever received treatment for an alcohol use disorder. One-fifth of participants had a history of a drug or alcohol use disorder. Most participants report that medicinal cannabis improves their pain symptomology, and are interested in alternative treatment options to opioid-based treatment regimens. PMID:25715068

  12. Urodynamic studies in female patients with multiple sclerosis.

    PubMed

    Beck, R P; Warren, K G; Whitman, P

    1981-02-01

    Patients with multiple sclerosis may have two fundamental, related problems in the lower urinary tract, i.e., urinary retention and/or urinary incontinence. Forty-six patients were assessed by urodynamic testing. Evidence of detrusor overactivity was seen in 40 patients (86.9%), elevated resting urethral pressures in 39 patients (84.8%), a positive bethanechol chloride (Urecholine) stress test in 24 patients (63.2%), and a significant residual urine in 26 patients (56.5%). Data were analyzed in an attempt to explain retention and incontinence in these patients. PMID:7468694

  13. Attending to Attendance. Fastback 450.

    ERIC Educational Resources Information Center

    Dougherty, John W.

    This fastback document examines student absenteeism and offers advice on what schools can do to improve attendance. It looks at truancy, absenteeism, and tardiness and how, since the first days of compulsory education, educators have had to deal with these obstacles to education. Since the 1970s absenteeism has been identified by many educators as…

  14. Mental Health and Substance Use Characteristics of Flight Attendants Enrolled in an In-Patient Substance Abuse Treatment Program

    ERIC Educational Resources Information Center

    Horton, Gail; Diaz, Naelys; McIlveen, John; Weiner, Michael; Mullaney, Donald

    2011-01-01

    The purpose of this study was to explore the prevalence rates of co-occurring mental health problems among 70 flight attendants in substance abuse treatment. Results indicated that flight attendants in treatment were more likely to experience alcohol dependency than drug dependency. A high proportion of participants reported clinical levels of…

  15. Post-stroke bacteriuria among stroke patients attending a physiotherapy clinic in Ghana: a cross-sectional study

    PubMed Central

    Donkor, Eric S; Akumwena, Amos; Amoo, Philip K; Owolabi, Mayowa O; Aspelund, Thor; Gudnason, Vilmundur

    2016-01-01

    Background Infections are known to be a major complication of stroke patients. In this study, we evaluated the risk of community-acquired bacteriuria among stroke patients, the associated factors, and the causative organisms. Methods This was a cross-sectional study involving 70 stroke patients and 83 age- and sex-matched, apparently healthy controls. Urine specimens were collected from all the study subjects and were analyzed by standard microbiological methods. Demographic and clinical information was also collected from the study subjects. For stroke patients, the information collected also included stroke parameters, such as stroke duration, frequency, and subtype. Results Bacteriuria was significantly higher among stroke patients (24.3%, n=17) than among the control group (7.2%, n=6), with a relative risk of 3.36 (confidence interval [CI], 1.40–8.01, P=0.006). Among the control group, all six bacteriuria cases were asymptomatic, whereas the 17 stroke bacteriuria cases comprised 15 cases of asymptomatic bacteriuria and two cases of symptomatic bacteriuria. Female sex (OR, 3.40; CI, 1.12–10.30; P=0.03) and presence of stroke (OR, 0.24; CI, 0.08–0.70; P=0.009) were significantly associated with bacteriuria. The etiology of bacteriuria was similar in both study groups, and coagulase-negative Staphylococcus spp. were the most predominant organisms isolated from both stroke patients (12.9%) and the control group (2.4%). Conclusion Stroke patients in the study region have a significantly higher risk of community-acquired bacteriuria, which in most cases is asymptomatic. Community-acquired bacteriuria in stroke patients appears to have little or no relationship with clinical parameters of stroke such as stroke subtype, duration and frequency. PMID:27051289

  16. Prevalence of depression and its associated factors among patients attending primary care settings in the post-conflict Northern Province in Sri Lanka: a cross-sectional study

    PubMed Central

    2014-01-01

    Background In Sri Lanka, civilians in the Northern Province were affected by a long-term armed conflict that ended in 2009. This study aims to describe the prevalence of depression and its associated factors among adult patients attending primary care settings in the Northern Province in Sri Lanka. Methods We report data from a cross-sectional patient morbidity registry established in 16 primary care facilities (12 Divisional Hospitals and 4 Primary Medical Care Units) in four districts of the Northern Province. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depression among all patients aged ≥18 years, between March and May 2013. A sample of 12,841 patient records was included in the analysis. A total score of ≥10 in the PHQ-9 was considered as major depression. Factors associated with major depression were tested using multivariable logistic regression analysis. Results The prevalence of major depression was 4.5% (95% CI: 4.1-4.9) and mild depression was 13.3% (95% CI: 12.7-13.9). The major depression was significantly higher in females than males (5.1% vs. 3.6%) and among unpaid family workers (6.0%) than any other category who earned an income (varied between 1.2% and 3.2%). The prevalence was rising significantly with advancing age, and ranged from 0.3% in the youngest to 11.6% in the elderly. Multivariable regression analysis revealed that the females have a higher risk for major depression than males (OR = 1.4; 95% CI: 1.1-1.7). Older patients were more likely to be depressed than younger patients, OR (95% CI) were 4.9 (1.9-12.5), 5.6 (2.2-14.0), 5.7 (2.3-14.2) and 4.7 (1.8-11.9) for the age groups 25–34, 35–49, 50–64, and ≥65 years respectively, in contrast to 18–24 year group. Disability in walking (OR = 7.5; 95% CI: 5.8-9.8), cognition (OR = 4.5; 95% CI: 3.6-5.6), self-care (OR = 2.6; 95% CI: 1.7-4.0), seeing (OR = 2.3; 95% CI: 1.8-3.0), and hearing (OR = 2.0; 95% CI: 1.5-2.5) showed significant associations with depression

  17. Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic.

    PubMed

    Gethin, Georgina; Byrne, Danielle; Tierney, Sean; Strapp, Helen; Cowman, Seamus

    2012-04-01

    Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management. PMID:21910829

  18. The Prevalence of Tonsilloliths and Other Soft Tissue Calcifications in Patients Attending Oral and Maxillofacial Radiology Clinic of the University of Iowa

    PubMed Central

    Bamgbose, Babatunde Olamide; Ruprecht, Axel; Timmons, Sherry; Qian, Fang

    2014-01-01

    Objective. The purpose of this study was to determine the prevalence of tonsiliths in patients attending the oral and maxillofacial radiology clinic of The University of Iowa and to determine if there is any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Study Design. This was a two-part study. The first part was a prevalence study whereas the second was a matched pair case-control study. The matched pair case-control study commenced after the prevalence study was concluded. No new or unusual radiographs were made in this study. The study only reviewed radiographs that were made for clinical purposes. Results. A total of 1524 pantomographs were reviewed and 124 subjects (53 males and 71 females) aged 9 years and 2 months to 87 years (mean age 52.6 years) were included for data analysis. Thirty-eight subjects had single tonsiliths whereas 86 subjects had multiple tonsiliths. The prevalence of tonsiliths in the study population was 8.14%. A total of 20 subjects were included in the second part of the study, comprising 10 each for matched pair case-control groups. The observations did not indicate any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Conclusion. The prevalence of tonsiliths in our study population was 8.14%. The observations in our study do not support any correlations between tonsiliths and calcifications in other body tissues, organs, or ducts. PMID:24587913

  19. Common Mental Disorder Symptoms among Patients with Malaria Attending Primary Care in Ethiopia: A Cross-Sectional Survey

    PubMed Central

    Tesfaye, Markos; Hanlon, Charlotte; Tessema, Fasil; Prince, Martin; Alem, Atalay

    2014-01-01

    Background Common Mental Disorders (CMDs) are frequent among patients attending primary care. In Africa, CMDs are often misdiagnosed as physical illnesses because many of the patients complain of somatic symptoms of mental distress. We explored whether there was difference in the levels of CMD symptoms between patients with thick film confirmed and clinical cases of malaria with negative thick film in primary care. Methods A cross-sectional comparative study was conducted on 300 adults with a clinical diagnosis of malaria in primary care centres in Jimma, Ethiopia. Patients were recruited consecutively until 100 cases of ‘malaria’ with a negative thick film and 200 cases of malaria with a positive thick film consented to participate. The 20-item Self-Reporting Questionnaire (SRQ-20) was used to measure CMD. The non-parametric Wilcoxon rank-sum test was used to explore the association between thick film result and CMD. Results Participants had a mean age of 28.2 (S.D = 10.9) years and the majority (57.3%) were women. The prevalence of high CMD symptoms (six or more symptoms on the SRQ-20) was 24.5%. Suicidal ideation was reported by 13.8% of the participants. CMD symptoms were significantly higher in patients who had taken medication prior to visiting the primary care (p = 0.012) and in those whose symptoms had been present for seven days or more (p = 0.041). There was no statistically significant association between level of CMD symptoms and having a negative thick film result (OR 0.98; 95%CI 0.92, 1.04) or objective presence of fever (OR 1.04; 95%CI 0.93, 1.15). Conclusions CMD symptoms among cases of malaria did not appear to be associated with a negative thick film result. The high levels of CMD symptoms, including suicidal ideation, calls for further studies to investigate the persistence and progression of these symptoms following resolution of the acute malarial episode. PMID:25268347

  20. [The psychosocial aspects of female patients with genital cancer].

    PubMed

    Buiuc, A I

    1996-01-01

    Revealing a diagnosis as cancer, usually generates various emotional and psychosocial response in the patients: anxiety, negation of reality, passivity and generalized state of shock and anguish; long term projects and personal responsibilities are annihilated, the image of death grows enormously. Genital cancer women patients also exhibits sexual problems which can seriously complicate the psychic representation of disease and impair family life. Our study comprised 20 women patients who were hospitalized, with genital cancer diagnosis (ovarian cancer, neoplasms of the cervix and of the endometrium); by anamnesis and further discussions we tried to establish the main elements which generated different psychologic reactions. The perception of the reality of the diagnosis was proved to depend on age, personality type, doctor-patient and family-patient relationship. Each stage of disease and each treatment applied generates individual psychologic reaction which can be alleviated by communication between doctor and patients, by a patient adapted language. Complexity of psychological and sometimes psychic reactions of such patients requires that a psycho-oncologist be included in the complex oncologic treatment team; deeper knowledge of the problems and employment of individual or group therapy (the patient's family included) may lead to better psychic response to the malady. PMID:9455456

  1. Risk factors and assessment for cardiovascular disease among HIV-positive patients attending a Nigerian tertiary hospital

    PubMed Central

    Osegbe, Ifeyinwa Dorothy; Soriyan, Oyetunji Olukayode; Ogbenna, Abiola Ann; Okpara, Henry Chima; Azinge, Elaine Chinyere

    2016-01-01

    Introduction Cardiovascular risk factors are prevalent in HIV-positive patients which places them at increased risk for cardiovascular disease (CVD). We aimed to determine the risk factors and risk assessment for CVD in HIV-positive patients with and without antiretroviral therapy. Methods This was a cross-sectional study of HIV-positive patients attending the Lagos University Teaching Hospital, Nigeria. Anthropometric and blood pressure measurements were performed; fasting lipid profile, plasma glucose, homocysteine and hsCRP were determined, as well as prevalences and risk assessments. Statistical tests were used to compare the groups and p-value <0.05 was considered to be significant. Results 283 subjects were recruited for this study (100 HIV-positive treatment-naive, 100 HIV-positive treated and 83 HIV negative controls). Compared to the controls, mean (sd) values were significantly higher among HIV-treated subjects: waist circumference = 88.7 (10.4), p = 0.035; systolic bp= 124.9 (20.7), p = 0.014; glucose= 5.54 (1.7), p = 0.015; triglyceride= 2.0 (1.2), p < 0.001; homocysteine= 10.9 (8.9-16.2), p = 0.0003; while hsCRP= 2.9 (1.4-11.6), p = 0.002 and HDL-C = 0.9 (0.4), p = < 0.0001 were higher among the HIV-naïve subjects. Likewise, higher prevalences of the risk factors were noted among the HIV-treated subjects except low HDL-C (p < 0.001) and hsCRP (p = 0.03) which were higher in the HIV-naïve group. Risk assessment using ratios showed high risk for CVD especially in the HIV-naïve group. The median range for Framingham risk assessment was 1.0 - 7.5%. Conclusion Risk factors and risk assessment for CVD are increased in HIV-positive patients with and without antiretroviral therapy. Routine evaluation and risk assessment for CVD irrespective of therapy status is necessary to prevent future cardiovascular events. PMID:27347295

  2. In vitro hemolytic effect of sulfadoxine/pyrimethamine and artemether/lumefantrine on malaria parasitized erythrocytes of female patients.

    PubMed

    Anaba, Festus Chinyereugo; Ahiante, Blessing Osemengbe; Pepple, Dagogo John

    2012-10-01

    G6PD is an X-linked gene enzyme that protects erythrocytes from hemolysis when they are exposed to antimalarial drugs because of the effects of the free radicals generated by these drugs. We investigated the effects of Fansidar ™ (Sulfatoxine/Pyrimethamine) and Coartem ™ (Artemether/Lumefantrine) on the hemolysis of malaria parasitized female erythrocytes. Twelve (12) malarious patients attending the University of Benin Teaching Hospital, Benin City, Nigeria, were used in this study. Ten (10) apparently healthy female students from the Medical School, University of Benin, acted as control. Low, normal (the recommended adult dose) and high doses of Fansidar ™ and Coartem ™ were used to determine the percentage hemolysis by checking the absorbance of the various samples. Data was analyzed by the Student's t-test and ANOVA with p<0.05 indicating the level of significance. At low doses of Fansidar ™ and Coartem ™, no hemolysis occurred, while at normal doses, Fansidar ™ showed no hemolysis but significant hemolysis (p<0.05) was observed in the Coartem ™ group. At high doses, both FansidarTM and CoartemTM caused significant (p<0.05) hemolysis. High doses of both drugs and normal dose of CoartemTM caused significant hemolysis. There was no hemolysis observed in the normal dose of FansidarTM and low doses for both drugs, similar to the trend reported for male subjects. PMID:23010004

  3. Endocrine disruptors and female cancer: Informing the patients (Review).

    PubMed

    Del Pup, Lino; Mantovani, Alberto; Luce, Amalia; Cavaliere, Carla; Facchini, Gaetano; Di Francia, Raffaele; Caraglia, Michele; Berretta, Massimiliano

    2015-07-01

    Pollutants altering the endocrine system, known as endocrine disruptors (ED), may modify the risk of female cancers. The carcinogenic effect of ED on humans has been confirmed by experimental studies for various substances including pesticides, DDT, dioxins, phthalates, bisphenol A, diethylstilbestrol, as well as heavy metals, but it is difficult to quantify precisely for several reasons hereby reviewed. Carcinogenesis is a complex and multifactorial mechanism that manifests itself over a long period of time, making difficult the detection of the specific contribution of the pollutants, whose absorbed dose is often unknown. The combined effect of various substances leads to complex interactions whose outcome is difficult to predict. These substances may accumulate and carry out their harmful effect on critical periods of life, probably also at doses considered harmless to an adult. ED can also have epigenetic adverse effects on the health of future generations. In conclusion, the carcinogenic effects of endocrine disruptors on female cancer types is plausible although additional studies are needed to clarify their mechanisms and entities. In the last part of the review we suggest ways to reduce ED exposure as it is mandatory to implement necessary measures to limit exposure, particularly during those periods of life most vulnerable to the impact of oncogenic environmental causes, such as the embryonic period and puberty. PMID:25998096

  4. Factors affecting the presence of depression, anxiety disorders, and suicidal ideation in patients attending primary health care service in Lithuania

    PubMed Central

    Bunevicius, Robertas; Peceliuniene, Jurate; Raskauskiene, Nijole; Bunevicius, Adomas; Mickuviene, Narseta

    2014-01-01

    Abstract Objective. The aim of this study was to establish prevalence, recognition, and risk factors for mental disorders and suicidal ideation in PC patients. Design. A cross-sectional survey based on standard mental health evaluation. Setting. Lithuanian primary care. Subjects. 998 patients from four urban PC clinics. Main outcome measures. Current mental disorders and suicidal ideation assessed using the Mini International Neuropsychiatric Interview (MINI). Results. According to the MINI, 27% of patients were diagnosed with at least one current mental disorder. The most common mental disorders were generalized anxiety disorder (18%) and major depressive episode (MDE) (15%), followed by social phobia (3%), panic disorder (3%), and post-traumatic stress disorder (2%). Some 6% of patients reported suicidal ideation. About 70% of patients with current mental disorder had no documented psychiatric diagnosis and about 60% received no psychiatric treatment. Greater adjusted odds for current MDE were associated with being widowed or divorced patients (odds ratio, OR = 1.8, 95% CI 1.2–2.8) and with lower education (OR = 1.6, 95% CI 1.1–2.3), while greater adjusted odds for any current anxiety disorder were found for women (OR = 1.9, 95% CI 1.3–2.8) and for patients with documented insomnia (OR = 2.2, 95% CI 1.2–4.2). Suicidal ideation was independently associated with use of antidepressants (OR = 5.4, 95% CI 1.7–16.9), with current MDE (OR = 2.9, 95% CI 1.5–5.8), and with excessive alcohol consumption (OR = 2.0, 95% CI 1.1–3.8). Conclusions. Depression, anxiety disorders, and suicidal ideation are prevalent but poorly recognized among PC patients. The presence of current MDE is independently associated with marital status and with lower education, while current anxiety disorder is associated with female gender and insomnia. Suicidal ideation is associated with current MDE, and with antidepressants and alcohol use. PMID:24533847

  5. Language lateralization in female patients with schizophrenia: an fMRI study.

    PubMed

    Sommer, I E C; Ramsey, N F; Mandl, R C W; Kahn, R S

    2003-04-01

    Gender differences in schizophrenia are among the most consistently reported findings in schizophrenia research. However, the biological substrate underlying these gender differences is still largely unknown. Differences in language lateralization between men and women may underlie some gender differences in schizophrenia. In previous functional imaging studies, language lateralization was found to be decreased in male schizophrenia patients as compared to healthy males, which was due to enhanced language activation of the right hemisphere as compared to the healthy males. It could be hypothesized that decreased language lateralization in schizophrenia is gender specific, i.e. decreased lateralization in male patients and normal lateralization in female patients. To test this hypothesis, language activation was measured in 12 right-handed female patients with schizophrenia and 12 healthy females, and compared to findings in 12 male patients and 12 male controls of an earlier study. Language lateralization was significantly lower in the female patients (0.44) as compared to the female controls (0.75), which was due to increased activation of the right-sided language areas (patients: 19 voxels; controls: 8 voxels), while left hemisphere activation was similar in patients and controls. When these data are compared to the male patients and controls, both patient groups had lower lateralization than their healthy counterparts, but there was no difference between male and female patients. In both sexes, decreased lateralization resulted from increased right hemispheric language activation, which suggests a failure to inhibit nondominant language areas in schizophrenia. These findings indicate that lower language lateralization in women is not likely to underlie gender differences in schizophrenia. PMID:12591582

  6. Multicentric Biatrial Myxoma in a Young Female Patient: Case Report

    PubMed Central

    Yoon, Sang Jeong; Park, Soon Chang; You, Yun Pyo; Kim, Bum Yong; Kim, Myong Kon; Jeong, Kyung Tae; Lee, Jae Won

    2000-01-01

    We report a case of multicentric, biatrial cardiac myxoma in a 29-year-old female who complained of exertional dyspnea, abdominal distension and peripheral edema. Any other associated skin lesions, breast mass or endocrine disorder presenting complex form were not seen on her. Also, there was no contributory medical history, hypertension and diabetes mellitus. By using transthoracic echocardiography, we identified a biatrial myxoma attached to the interatrial septum. During surgical excision, we found a large right atrial myxoma with extension through the fossa ovalis into the left atrium and small myxoma attached to the right atrial free wall. After successful resection of interatrial septum and free wall, atrial septal defect was created during the resection and safely repaired by bovine pericardial patch. PMID:11242813

  7. Acquired immunodeficiency syndrome among patients attending hemophilia treatment centers and mortality experience of hemophiliacs in the United States.

    PubMed

    Johnson, R E; Lawrence, D N; Evatt, B L; Bregman, D J; Zyla, L D; Curran, J W; Aledort, L M; Eyster, M E; Brownstein, A P; Carman, C J

    1985-06-01

    The acquired immunodeficiency syndrome (AIDS) was first recognized among hemophiliacs in 1982. The authors have conducted investigations to determine the onset and incidence of AIDS among hemophiliacs and to determine trends in hemophilia mortality since the introduction of clotting-factor concentrates in the late 1960s. A survey of United States hemophilia treatment centers, supported by the Centers for Disease Control and the National Hemophilia Foundation, defined a population of hemophiliacs which was monitored for AIDS cases through June 1984. Death reports from the United States Vital Statistics System and from the hemophilia treatment center survey provided mortality trends for 1968-1979 and for 1978-1982, respectively. The results of these investigations demonstrate the following points. 1) The AIDS epidemic is a new and important cause of illness and mortality among hemophiliacs, although a very low incidence of AIDS among hemophiliacs prior to 1982 cannot be ruled out. 2) The AIDS cases who attended the surveyed hemophilia treatment centers were distributed throughout the United States and were older than hemophilia treatment center patients without AIDS. AIDS cases also used more lyophilized clotting-factor concentrate, but only a small number of cases were reported with this information. 3) Improved care for hemophilia, including the use of clotting-factor concentrates, dramatically reduced hemophilia mortality rates during the 1970s. 4) In 1982, hemorrhage was the major cause of death among hemophiliacs. Deaths from non-alcoholic liver disease were also increased. AIDS incidence among hemophilia treatment center attendees was stable at 0.6 cases per 1,000 hemophilia treatment center attendees per year during 1982 and 1983 but increased sharply to 5.4 cases per 1,000 during the first quarter of 1984. PMID:4014173

  8. [Problems of female cancer patients and their coping behavior].

    PubMed

    Herschbach, P; Rosbund, A M; Brengelmann, J C

    1985-08-01

    A questionnaire was developed with the aim of gathering basic information relevant to the psychosocial aftercare of cancer patients. The questionnaire deals with concrete everyday problems of breast and genital cancer patients, it allowed moreover an analysis of situation-specific coping strategies. The sample consists of 480 breast and genital cancer patients from various aftercare institutions. The results show a wide distribution of problems in many life situations. The most common problems were specific forms of anxiety, clinical symptoms and household problems. On the other hand, certain problems were identified which, although less common, proved to be extremely stressful for the affected patients. The analysis of different subgroups points to the large relative importance of sociodemographic and aftercare factors in the individual stress profile. With respect to coping behavior, the results show that neither personality-oriented nor situation-specific concepts alone provide an adequate approach. Coping strategies are not general but rather tied in specific ways to personality traits and to the form or degree of the problems. PMID:3912691

  9. Electrophysiological Neuroimaging using sLORETA Comparing 22 Age Matched Male and Female Schizophrenia Patients

    PubMed Central

    Eugene, Andy R.; Masiak, Jolanta; Kapica, Jacek; Masiak, Marek

    2015-01-01

    Introduction The purpose of this electrophysiological neuroimaging study was to provide a deeper mechanistic understanding of both olanzapine and risperidone pharmacodynamics relative to gender. In doing so, we age-matched 22 men and women and evaluated their resting-state EEG recordings and later used standard low resolution brain Electrotomography to visualize the differences in brain activity amongst the two patient groups. Methods In this investigation, electroencephalogram (EEG) data were analyzed from male and female schizophrenia patients treated with either olanzapine or risperidone, both atypical antipsychotics, during their in-patient stay at the Department of Psychiatry. Twenty-two males and females were age-matched and EEG recordings were analyzed from 19 Ag/AgCl electrodes. Thirty-seconds of resting EEG were spectrally transformed in standardized low resolution electromagnetic tomography (sLORETA). 3D statistical non-paramentric maps for the sLORETA Global Field Power within each band were finally computed. Results The results indicated that, relative to males patients, females schizophrenia patients had increased neuronal synchronization in delta frequency, slow-wave, EEG band located in the dorsolateral prefrontal cortex, within the middle frontal gyrus (t= -2.881, p < 0.03580). These findings suggest that females experience greater dopamine (D2) receptor and serotonin (5-HT2) receptor neuronal blockade relative to age-matched males. Further, our finding provided insight to the pharmacodynamics of second-generation antipsychotics olanzapine and risperidone. Conclusion When compared to male patients, female patients, suffering from schizophrenia, have D2 and 5-HT2 receptors that are blocked more readily than age-matched male schizophrenia patients. Clinically, this may translate into a quicker time to treatment-response in females as compared to male patients. PMID:26617679

  10. [65-year old female patient with persistent hypercalcemia].

    PubMed

    Wiedmann, M; Kassahun, W; Deckert, F; Tröltzsch, M; Sturmvoll, M; Führer, D

    2007-12-01

    A 65-year old patient presented with newly diagnosed hypercalcemia and elevated parathyroid hormone levels. Exploration of parathyroid glands was performed under the diagnosis of primary hyperparathyroidism and was combined with thyreoidectomy due to concomittant multinodular goiter. However, no parathyroid adenoma was identified despite careful exploration. Therefore, the operation was terminated and an ectopic adenoma was suspected. A (99m)Tc-sestamibi scintigraphy with SPECT, neck ultrasound, neck CT scan with contrast media and selective venous sampling were performed for further localization of the adenoma. A single adenoma localized in the submandibular area of the left jaw was suspected and confirmed during surgical reexploration. Postoperatively, parathyroid hormone levels were below detection level and the patient required short-term calcium supplementation for symptomatic hypocalcemia. PMID:17965847

  11. High uptake of hepatitis C virus treatment in HIV/hepatitis C virus co-infected patients attending an integrated HIV/hepatitis C virus clinic.

    PubMed

    Kieran, J; Dillon, A; Farrell, G; Jackson, A; Norris, S; Mulcahy, F; Bergin, C

    2011-10-01

    Hepatitis C virus (HCV) is a major cause of liver disease in HIV-infected patients. The HCV treatment outcomes and barriers to HCV referral were examined in a centre with a HIV/HCV co-infection clinic. Patients who were antibody positive for both HIV and HCV between 1987 and January 2009 were identified. A retrospective chart review was undertaken. Multivariate analysis was performed to assess predictors of HCV clinic referral. Data were collected on 386 HIV/HCV patients; 202/386 had been referred to the co-infection clinic and 107/202 had HCV treatment. In addition, 29/202 were undergoing pretreatment work-up. Overall sustained virologic response (SVR) was 44%; SVR was equivalent in those who acquired HIV/HCV infection from intravenous drug use (IDU) and others. On multivariate analysis, patients who missed appointments, were younger, with active IDU and advanced HIV and who were not offered HCV treatment were less likely to be referred to the clinic. Patients attending the clinic were more likely to have been screened for hepatocellular carcinoma than those attending the general HIV service. Two-thirds of patients referred to the clinic had engaged with the HCV treatment programme. Dedicated co-infection clinics lower the threshold for treatment and improve management of liver disease in co-infected patients. PMID:21998177

  12. Female Genital Dialogues: Female Genital Self-Image, Sexual Dysfunction, and Quality of Life in Patients With Vitiligo With and Without Genital Affection.

    PubMed

    Sarhan, Deena; Mohammed, Ghada F A; Gomaa, Amal H A; Eyada, Moustafa M K

    2016-01-01

    Vitiligo has a major effect on sexual health because of the disfiguring skin lesions affecting self-image and self-esteem. However, this topic has not explored. This article aimed to assess the effect of vitiligo on genital self-image, sexual function, and quality of life in female patients. This cross-sectional study included 50 sexually active women with vitiligo and 25 women without vitiligo. All participants subjected to full history taking and examination. Extent of vitiligo was assessed with the Vitiligo Area Scoring Index score, sexual function with the Female Sexual Function Index, genital self-image with Female Genital Self-Image Score and quality of life with the Dermatology Life Quality Index questionnaires. The main outcome measures were correlation between Vitiligo Area Scoring Index, Female Genital Self-Image Score, Female Sexual Function Index, and Dermatology Life Quality Index domains was determined using t test and Pearson correlation. This study revealed a negative correlation between the Vitiligo Area Scoring Index score and sexual satisfaction. Vitiligo Area Scoring Index and Dermatology Life Quality Index score was significantly correlated with Arabic Version of the Female Genital Self-Image Score alone and with Arabic Version of the Female Sexual Functioning Index alone and with both the Arabic Version of the Female Genital Self-Image Score and the Arabic Version of the Female Sexual Functioning Index (p <.05). Sexual and psychological assessment of patients with vitiligo is imperative to improve outcomes and increase patients' compliance with treatment. PMID:25650731

  13. [Procedures for fertility preservation in female cancer patients].

    PubMed

    Langmár, Zoltán; Mátrai, Máté; Bánhidy, Ferenc; Csömör, Sándor

    2007-11-25

    Improving survival rates and quality of life following modern combined cancer treatments have resulted a growing number of patients requesting maintenance of reproductive functions. Several methods are currently available to maintain fertility during oncotherapy. Even though most of them are still experimental and their efficacy and safety have not been determined, the future for fertility preservation in women with cancer is promising. In vitro fertilization with embryo cryopreservation offers an established method, but time to delay cancer treatment could be risky regarding the progression of several cancer types. Moreover, exposure to a high oestrogen milieu during ovarian stimulation is undesirable when patients have estrogen-sensitive malignant tumours. Cryopreservation of mature oocytes following in vitro fertilization and intracytoplasmatic sperm injection offers advantages, but it is still limited due to its low success rate. Emerging techniques of ovarian tissue cryopreservation followed by autotransplantation have been clinically explored. Novel technologies of tissue freezing and thawing promise improving results. However, only one live birth following autotransplanted frozen-thawed ovarian tissue has been established. This procedure can be offered in the future for prepubertal girls before cancer treatment to maintain future fertility. Gonadal tissue cryopreservation and transplantation should be considered experimental in humans for the present time until greater evidence regarding efficacy and safety is accrued. PMID:18003580

  14. Identification of Intellectual Disability Genes in Female Patients with a Skewed X-Inactivation Pattern.

    PubMed

    Fieremans, Nathalie; Van Esch, Hilde; Holvoet, Maureen; Van Goethem, Gert; Devriendt, Koenraad; Rosello, Monica; Mayo, Sonia; Martinez, Francisco; Jhangiani, Shalini; Muzny, Donna M; Gibbs, Richard A; Lupski, James R; Vermeesch, Joris R; Marynen, Peter; Froyen, Guy

    2016-08-01

    Intellectual disability (ID) is a heterogeneous disorder with an unknown molecular etiology in many cases. Previously, X-linked ID (XLID) studies focused on males because of the hemizygous state of their X chromosome. Carrier females are generally unaffected because of the presence of a second normal allele, or inactivation of the mutant X chromosome in most of their cells (skewing). However, in female ID patients, we hypothesized that the presence of skewing of X-inactivation would be an indicator for an X chromosomal ID cause. We analyzed the X-inactivation patterns of 288 females with ID, and found that 22 (7.6%) had extreme skewing (>90%), which is significantly higher than observed in the general population (3.6%; P = 0.029). Whole-exome sequencing of 19 females with extreme skewing revealed causal variants in six females in the XLID genes DDX3X, NHS, WDR45, MECP2, and SMC1A. Interestingly, variants in genes escaping X-inactivation presumably cause both XLID and skewing of X-inactivation in three of these patients. Moreover, variants likely accounting for skewing only were detected in MED12, HDAC8, and TAF9B. All tested candidate causative variants were de novo events. Hence, extreme skewing is a good indicator for the presence of X-linked variants in female patients. PMID:27159028

  15. Attendance Rates in a Workplace Predict Subsequent Outcome of Employment-Based Reinforcement of Cocaine Abstinence in Methadone Patients

    ERIC Educational Resources Information Center

    Donlin, Wendy D.; Knealing, Todd W.; Needham, Mick; Wong, Conrad J.; Silverman, Kenneth

    2008-01-01

    This study assessed whether attendance rates in a workplace predicted subsequent outcome of employment-based reinforcement of cocaine abstinence. Unemployed adults in Baltimore methadone programs who used cocaine (N = 111) could work in a workplace for 4 hr every weekday and earn $10.00 per hour in vouchers for 26 weeks. During an induction…

  16. Chlamydia, mycoplasmas, ureaplasmas, and yeasts in the lower genital tract of females. Comparison between a group attending a venereal disease clinic and a control group.

    PubMed

    Møller, B R; Sparre Jørgensen, A; From, E; Stenderup, A

    1985-01-01

    162 women were investigated. Group I consisted of 85 women, who were partners to men with non-gonococcal urethritis (NGU) or presented macroscopic signs of cervicitis; patients who had harbored Neisseria gonorrhoeae were excluded from the study. Group II was a control group of 77 women without any complaints from the urogenital tract and with normal findings at pelvic examination. All the women were tested for infection with Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Candida albicans. In group I, chlamydiae and mycoplasmas were recovered in 44% and 36%, respectively, the corresponding figures for the control group (group II) being 5% and 19%. The difference is highly significant. No such difference between the two groups was found for ureaplasmas. Sixteen percent of the patients in group I were positive for C. albicans; 12% were positive in group II. Fifty per cent of asymptomatic NGU-partners were chlamydia-positive, and about one-third of patients with either dysuria or vaginal discharge harbored the organism. No difference in the isolation frequency of mycoplasmas was observed between asymptomatic partners to male NGU carriers and women with increased vaginal discharge, whereas the organism was isolated more frequently from patients with dysuria. Fifty-nine per cent of patients with cervicitis were chlamydia-positive, compared with 30% of patients with normal cervical appearance and normal vaginal discharge. Samples obtained from the cervix were more often positive than samples from the urethra. In conclusion, if samples can be taken from only one of the two sites in patients with lower genital tract infection, the cervix is the optimal sampling site. PMID:3885669

  17. Fertility preservation in female cancer patients: An overview

    PubMed Central

    Mahajan, Nalini

    2015-01-01

    Fertility preservation is becoming increasingly important to improve the quality of life in cancer survivors. Despite guidelines suggesting that discussion of fertility preservation should be done prior to starting cancer therapies, there is a lack of implementation in this area. A number of techniques are available for fertility preservation, and they can be used individually or together in the same patient to maximize efficiency. Oocyte and embryo cryopreservation are now established techniques but have their limitations. Ovarian tissue cryopreservation though considered experimental at present, has a wider clinical application and the advantage of keeping the fertility window open for a longer time. Both chemotherapy and radiotherapy have a major impact on reproductive potential and fertility preservation procedures should be carried out prior to these treatments. The need for fertility preservation has to be weighed against morbidity and mortality associated with cancer. There is thus a need for a multidisciplinary collaboration between oncologists and reproductive specialists to improve awareness and availability. PMID:25838742

  18. Fertility preservation in female cancer patients: An overview.

    PubMed

    Mahajan, Nalini

    2015-01-01

    Fertility preservation is becoming increasingly important to improve the quality of life in cancer survivors. Despite guidelines suggesting that discussion of fertility preservation should be done prior to starting cancer therapies, there is a lack of implementation in this area. A number of techniques are available for fertility preservation, and they can be used individually or together in the same patient to maximize efficiency. Oocyte and embryo cryopreservation are now established techniques but have their limitations. Ovarian tissue cryopreservation though considered experimental at present, has a wider clinical application and the advantage of keeping the fertility window open for a longer time. Both chemotherapy and radiotherapy have a major impact on reproductive potential and fertility preservation procedures should be carried out prior to these treatments. The need for fertility preservation has to be weighed against morbidity and mortality associated with cancer. There is thus a need for a multidisciplinary collaboration between oncologists and reproductive specialists to improve awareness and availability. PMID:25838742

  19. Dietary Intake In Adult Female Coeliac Disease Patients In Slovenia

    PubMed Central

    Mičetić-Turk, Dušanka

    2016-01-01

    Abstract Objectives The aim of the study was to assess dietary intake of coeliac disease (CD) patients and to determine if they are meeting the dietary reference values for a balanced diet. Subjects/Methods 40 women with CD, aged from 23 to 76 participated in our study. Total daily intake was assessed by a three-day food diary. Resting metabolic rate (RMR) was calculated using Harris-Benedict equation. Considering physical activity level (PAL) 1.4, the recommended total energy expenditure (TEE) value was determined. The data was evaluated with professional evaluation software Prodi and statistically analysed. Results 40 participants returned the food diary. The average energy intake was significantly too low to ensure the meeting of all-day energy needs (p<0.05). The meals contained a recommended proportion of protein, but a statistically significantly higher proportion of fat (p<0.05), lower proportion of carbohydrates and a significantly lower intake of dietary fibre (p<0.05). Regarding macro-, micro- elements and vitamins, there was a significant lack in the intake of calcium and iodine, folic acid, vitamin D and vitamin A (p<0.05), meanwhile iron intake was at the lower limit of the recommended intake, whereas zinc, potassium and vitamin K intake were significantly higher according to the recommended values, but were comparable with the intake of the general population in the Central European area. Conclusion Even in subjects with adequate or low daily energy intake, their meals contained too much fat, too few carbohydrates and dietary fibre as well as inorganic substances. The patients with CD should get regular nutritional monitoring and education on the quality and balance of a gluten-free diet. PMID:27284377

  20. System-level and patient-level explanations for non-attendance at diabetic retinopathy screening in Sutton and Merton (London, UK): a qualitative analysis of a service evaluation

    PubMed Central

    Strutton, R; Du Chemin, A; Stratton, I M; Forster, A S

    2016-01-01

    Objectives Non-attendance at diabetic retinopathy screening has financial implications for screening programmes and potential clinical costs to patients. We sought to identify explanations for why patients had never attended a screening appointment (never attendance) in one programme. Design Qualitative analysis of a service evaluation. Setting One South London (UK) diabetic eye screening programme. Participants and procedure Patients who had been registered with one screening programme for at least 18 months and who had never attended screening within the programme were contacted by telephone to ascertain why this was the case. Patients’ general practices were also contacted for information about why each patient may not have attended. Framework analysis was used to interpret responses. Results Of the 296 patients, 38 were not eligible for screening and of the 258 eligible patients, 159 were not contactable (31 of these had phone numbers that were not in use). We obtained reasons from patients/general practices/clinical notes for non-attendance for 146 (57%) patients. A number of patient-level and system-level factors were given to explain non-attendance. Patient-level factors included having other commitments, being anxious about screening, not engaging with any diabetes care and being misinformed about screening. System-level factors included miscommunication about where the patient lives, their clinical situation and practical problems that could have been overcome had their existence been shared between programmes. Conclusions This service evaluation provides unique insight into the patient-level and system-level reasons for never attendance at diabetic retinopathy screening. Improved sharing of relevant information between providers has the potential to facilitate increased uptake of screening. Greater awareness of patient-level barriers may help providers offer a more accessible service. PMID:27194319

  1. Kyol Goeu (‘Wind Overload’) Part II: Prevalence, Characteristics, and Mechanisms of Kyol Goeu and Near-Kyol Goeu Episodes of Khmer Patients Attending a Psychiatric Clinic

    PubMed Central

    Hinton, Devon; Um, Khin; Ba, Phalnarith

    2009-01-01

    Kyol goeu (literally, ‘wind overload’) is an orthostatically triggered syncopal syndrome often found among Khmer refugees in the US. In the present study, 36 of 100 (36%) Khmer patients attending a psychiatric clinic were found to have suffered a kyol goeu episode in the past, whereas 60 of 100 (60%) patients had experienced a near-kyol goeu event in the last six months. Following a survey-based characterization of kyol goeu, as well as the presentation of case vignettes, the article discusses six mechanisms resulting in the high prevalence of the syndrome. The article concludes by comparing kyol goeu and ataque de nervios. PMID:20808711

  2. Attitudes of Patients in Developing Countries Toward Participating in Clinical Trials: A Survey of Saudi Patients Attending Primary Health Care Services

    PubMed Central

    Al-Dakhil, Lateefa O.; Alanazy, Reem; Al-Hamed, Rakan E.; Al-Mandeel, Hazem; Alobaid, Abdulaziz

    2016-01-01

    Objectives Clinical trials are experimental projects that include patients as subjects. A number of benefits are directly associated with clinical trials. Healthcare processes and outcomes can be improved with the help of clinical trials. This study aimed to assess the attitudes and beliefs of patients about their contribution to and enrolment in clinical trials. Methods A cross-sectional study design was used for data collection and analysis. A questionnaire was developed with six categories to derive effective outcomes. Results Of the 2000 participants approached to take part in the study, 1081 agreed. The majority of the study population was female, well educated, and unaware of clinical trials. Only 324 subjects (30.0%) had previously agreed to participate in a clinical trial. The majority (87.1%) were motivated to participate in clinical trials due to religious aspects. However, fear of any risk was the principal reason (79.8%) that reduced their motivation to participate. Conclusions The results of this study revealed that patients in Saudi Arabia have a low awareness and are less willing to participate in clinical trials. Different motivational factors and awareness programs can be used to increase patient participation in the future. PMID:27403241

  3. Gender Differences in Undergraduate Attendance Rates

    ERIC Educational Resources Information Center

    Woodfield, Ruth; Jessop, Donna; McMillan, Lesley

    2006-01-01

    Research on students' attendance rates has focused mainly on the effects of personality variables and cognitive ability, rather than on the impact on degree outcomes. More specifically, there is scant information relating to the question of whether male and female undergraduate students have differential practices in relation to attendance,…

  4. Level of control among patients with type 2 diabetes mellitus attending diabetic clinic under family medicine compared to diabetic clinic under endocrinology

    PubMed Central

    AlHabdan, Mohammed A; AlAteeq, Mohammed A; AlJurbou, Fiasal I

    2016-01-01

    Objectives To assess and compare level of control among patients with type 2 diabetes mellitus attending diabetic clinic under family medicine service and patients attending diabetic clinics under endocrinology service, and to explore the effect of different variables on the level of control in both groups. Methods Retrospective cross-sectional study by reviewing medical records of patients with type 2 diabetes mellitus and laboratory studies from Hospital Information System at King Abdul-Aziz Medical City, National Guard, Riyadh – Saudi Arabia using predesigned sheet for data collection. Results Among 352 patients enrolled in the study, 176 (50%) patients were from the family medicine setting and 176 (50%) patients were from the hospital setting. The mean glycosylated hemoglobin for the whole study population was 8.97±1.87. There was no significant difference between the two groups in regard to level of control (9.01±1.75 in the family medicine setting compared to 8.93±1.98 in the hospital setting). No significant correlation was found between level of control and age, duration of disease and number of follow-up visits in both settings. Conclusion Patients with type 2 diabetes mellitus in this study were found to be poorly controlled in both the settings, diabetic clinic under family medicine and diabetic clinic under endocrinology. More research should be done to explore quality of care in a family medicine setting for patients with type 2 diabetes mellitus, as such a setting is expected to be more accessible, more convenient, and more cost effective to patients. PMID:27143944

  5. Atrial Fibrillation is Associated With Morphine Treatment in Female Breast Cancer Patients

    PubMed Central

    Lee, Cynthia Wei-Sheng; Muo, Chih-Hsin; Liang, Ji-An; Lin, Ming-Chia; Kao, Chia-Hung

    2016-01-01

    Abstract We investigated the relationship between morphine treatment and the risk of atrial fibrillation (AF) in female patients with breast cancer. We identified a malignancy cohort of 73,917 female breast cancer patients without an AF history before the date of breast cancer diagnosis between 2000 and 2010 by using the Longitudinal Health Insurance Database for Catastrophic Illness Patients in Taiwan. This malignancy cohort was divided into morphine and comparison cohorts comprising 18,671 and 55,246 patients, respectively, and the incidences of newly diagnosed AF were calculated. We used the Cox proportional hazard model with time-dependent exposure covariates to estimate the risk of AF. The effect of morphine was assessed through multivariable Cox proportional hazard regression controlling for age, the Charlson comorbidity index (CCI) score, and the use of bisphosphonates and paclitaxel. Compared with nonmorphine users, patients who received morphine exhibited a 4.37-fold (95% CI = 3.56–5.36) increase in the risk of developing AF. The risk of AF increased as the CCI score increased, but decreased in patients with tamoxifen treatment. This risk is especially significant in current morphine users of all ages and with low CCI score. AF risk increased as the duration of morphine use lengthened (P for trend <0.0001). The incidence of AF in female breast cancer patients in Taiwan is associated with morphine, but prevented by tamoxifen treatment. PMID:26986153

  6. Female Patient and Physician Communication and Discussion of Gynecological Health Care Issues.

    ERIC Educational Resources Information Center

    Wheeless, Virginia Eman

    1987-01-01

    Indicates that a female patient's trust in, receptivity to, and communication apprehension regarding her physician constitute significant predictors of her (1) likelihood of discussing health care issues, (2) knowledge of gynecological health needs, and (3) feelings toward the gynecologist during examination. Finds that the physician's gender does…

  7. Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia

    PubMed Central

    Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik

    2016-01-01

    Background We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). Methods This case–control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Results Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). Conclusion SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM. PMID:26937190

  8. Cosmetic selection of skin incision for resection of choledochal cyst in young female patients

    PubMed Central

    Choi, Jong-Woo; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan

    2016-01-01

    Backgrounds/Aims Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. Methods During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated. Results The patients underwent mini-laparotomy through either a right subcostal incision (n=8) or an upper midline incision (n=3). The mean length of skin incision was 10 cm for right subcostal incisions and 9 cm for upper midline incisions. It took approximately 1 hour to repair the operative wound meticulously in both groups. At the 6 month to 1 year follow-up, a slight bulge on the skin scar was observed in 3 (37.5%) patients of the right subcostal incision group and 1 (33.3%) patient of the upper midline incision group. Conclusions The results of this preliminary study support the claim that cosmetic effect of the upper midline incision for CCD surgery appears to be non-inferior to that of the right subcostal incision if the incision is placed accurately and repaired very meticulously. PMID:27621750

  9. Effectiveness of an intervention promoting the female condom to patients at sexually transmitted disease clinics.

    PubMed Central

    Artz, L; Macaluso, M; Brill, I; Kelaghan, J; Austin, H; Fleenor, M; Robey, L; Hook, E W

    2000-01-01

    OBJECTIVES: This study evaluated a behavioral intervention designed to promote female condoms and reduce unprotected sex among women at high risk for acquiring sexually transmitted diseases (STDs). METHODS: The effect of the intervention on barrier use was evaluated with a pretest-posttest design with 1159 female STD clinic patients. RESULTS: Among participants with follow-up data, 79% used the female condom at least once and often multiple times. More than one third of those who completed the study used female condoms throughout follow-up. Use of barrier protection increased significantly after the intervention, and high use was maintained during a 6-month follow-up. To account for attrition, the use of protection by all subjects was projected under 3 conservative assumptions. The initial visit and termination visit projections suggest that use increased sharply after the intervention and declined during follow-up but remained elevated compared with the baseline. CONCLUSIONS: Many clients of public STD clinics will try, and some will continue, to use female condoms when they are promoted positively and when women are trained to use them correctly and to promote them to their partners. A behavioral intervention that promotes both female and male condoms can increase barrier use. PMID:10667185

  10. Risk of abnormal triple screen for Down syndrome is significantly higher in patients with female fetuses.

    PubMed

    Spong, C Y; Ghidini, A; Stanley-Christian, H; Meck, J M; Seydel, F D; Pezzullo, J C

    1999-04-01

    Previous studies have shown that mid-trimester maternal serum alpha-fetoprotein (AFP) levels are significantly higher and human chorionic gonadotrophin (hCG) levels significantly lower in women with male compared with female fetuses. We have evaluated whether triple-screen criteria are more likely to identify women with female fetuses as at risk for Down syndrome. From the Georgetown University genetics database we obtained the absolute values and corresponding multiples of the median (MoM) for AFP, hCG and unconjugated oestriol (uE3) in singleton gestations for the period database November 1992 July 1996. A Down syndrome risk of 1/270 or greater at mid-trimester was considered as high risk. A total of 977 patients with triple screen and outcome information were identified, including 502 female and 475 male fetuses. Patients with female fetuses were significantly more likely to have lower serum AFP (p=0.003) and a positive triple screen for Down syndrome (72 (14 per cent) versus 45 (9 per cent), p<0.02) than those with male fetuses. The gestational age at triple screen, maternal serum hCG and uE3, race and diabetes were not significantly different between the two groups. Since Down syndrome is less common in female than male fetuses, and the rates of female and male Down syndrome fetuses detected by triple screen and subsequent amniocentesis are not significantly different, the excess of positive mid-trimester maternal serum triple screen in women with female fetuses is likely due to false-positive results. PMID:10327139

  11. Factors associated with bone metabolism in acromegalic patients: hypogonadism and female gender.

    PubMed

    Tütüncü, N B; Erbaş, T

    2004-06-01

    The purpose of the study was to determine the factors associated with bone metabolism in acromegalic patients. Thirty three patients with acromegaly who had been followed on a regular basis in the endocrinology clinic were enrolled for the study. Among the factors acting upon bone metabolism, age, gender, body mass index (BMI), duration and activity of the disease, length of remission, treatment modalities and functional status of the pituitary were evaluated. Their influences on the determinants of bone remodelling and bone mineral density (BMD) were tried to be elucidated. The median age of the 33 acromegalics (19 females, 14 males) was 39.73 +/- 10.1 years. Twenty-three patients (9 males and 14 females) were eugonadal. Ten patients had been diagnosed with history of at least one year of untreated hypogonadism (5 males and 5 females; for 1 - 10 years). The BMD values of the lumbar vertebrae, the femur and the radius were correlated with each other. Patients were grouped according to their T-scores as decreased, normal, and increased BMD. Groups were similar with regard to age, BMI, gender, duration of disease, and remission, GH, IGF-1, IGFBP-3 levels, markers of bone turnover. Presence of hypogonadism and duration of hypogonadism revealed statistically significant difference among the 3 groups (p = 0.005 and p = 0.035, respectively). Hypogonadal acromegalic patients had decreased BMD compared to eugonadal acromegalics and healthy population while the eugonadal female acromegalic patients revealed increased BMD of lumbar vertebrae, femur, and distal radius compared to the sex-matched healthy population. PMID:15216451

  12. Design and methods of the Gentle Cardiac Rehabilitation Study – A behavioral study of tai chi exercise for patients not attending cardiac rehabilitation

    PubMed Central

    Salmoirago-Blotcher, Elena; Wayne, Peter; Bock, Beth C; Dunsiger, Shira; Wu, Wen-Chih; Stabile, Loren; Yeh, Gloria

    2015-01-01

    Introduction Cardiac rehabilitation (CR) programs reduce overall and cardiovascular mortality in patients with a history of acute coronary events or revascularization procedures, but only 30 % of patients enroll in CR and attrition rates reach up to 60 %. Tai chi, a mind-body practice based on light/moderate aerobic exercise accompanied by meditative components could be a possible exercise option for patients who do not attend CR. Methods/Design Sixty patients will be randomized to a “LITE ” condition (one tai chi session twice weekly for 12 weeks) or to a “PLUS” condition (one tai chi session 3 times weekly for 12 weeks, followed by maintenance classes 1–2 times weekly for an additional 12 weeks). Measurements will be conducted at baseline, 3-, 6-, and 9 months after enrollment. The primary outcome is to determine the feasibility, acceptability and safety of each dose. Secondary outcomes include estimates of effect size of each dose on accelerometry-assessed physical activity; the proportion of patients meeting current recommendations for physical activity; and measures of fitness, quality of life, body weight, and sleep. In addition, we will collect exploratory information on possible mediators (exercise self-efficacy, perceived social support, resilience, mindfulness, and depression). Conclusions Findings from this pilot study will provide preliminary indications about the usefulness of tai chi as an exercise option for patients not attending traditional CR programs. Results will also shed light on the possible mechanisms by which tai chi practice may improve overall physical activity among patients with atherosclerotic coronary heart disease. PMID:26115880

  13. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... health and safety of the patient and other persons likely to come into contact with him, including in the... STATION MANAGEMENT Transfer of Patients § 35.22 Attendants. Patients shall be transferred by such means... 42 Public Health 1 2010-10-01 2010-10-01 false Attendants. 35.22 Section 35.22 Public...

  14. 42 CFR 35.22 - Attendants.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... health and safety of the patient and other persons likely to come into contact with him, including in the... STATION MANAGEMENT Transfer of Patients § 35.22 Attendants. Patients shall be transferred by such means... 42 Public Health 1 2011-10-01 2011-10-01 false Attendants. 35.22 Section 35.22 Public...

  15. Gonadal malignancy in 202 female patients with disorders of sex development containing Y-chromosome material.

    PubMed

    Jiang, Jian-Fa; Xue, Wei; Deng, Yan; Tian, Qin-Jie; Sun, Ai-Jun

    2016-04-01

    The objective of this study was to examine risks for gonadal malignancy in a large sample of adult female patients with disorders of sex development (DSD). A retrospective-observational study was conducted from July 1992 to March 2015 and 202 women with DSD were enrolled. Tumor risks for different types of DSD were measured. We found that the patients' total gonadal-malignancy risk was 18.3% (37/202). Tumors included gonadoblastoma (n = 11), seminoma (n = 8), dysgerminoma (n = 5), choriocarcinoma (n = 1), sertoli cell tumors (n = 11), and leydig cell tumors (n = 1). The incidence of gonadal malignancy in patients with complete androgen insensitivity syndrome (CAIS), pure 46, XY gonadal dysgenesis, 45 X/46 XY mixed gonadal dysgenesis, 17α-hydroxylase/17, 20-lyase deficiency and partial androgen insensitivity syndrome (PAIS) were 27.1% (13/48), 22.4% (15/67), 10.9% (5/46), 10% (2/20) and 9.5% (2/21), respectively. Our results suggest that the incidence of gonadal malignancy increases with age for female patients with Y-chromosome material. Upon diagnoses, immediate, prophylactic gonadectomies should be considered for adult female patients with DSD containing Y chromosome material if they cannot receive regular follow-ups. PMID:26608236

  16. [Symptom portrayal and initial therapeutic relationship of female and male patients in the initial psychoanalytic interview].

    PubMed

    Grande, T; Wilke, S; Nübling, R

    1992-01-01

    The transcripts of psychoanalytic initial interviews are analyzed in using the "Structural Analysis of Social Behavior" (SASB) by L. S. Benjamin. This instrument was chosen to detect how male and female patients talk about their symptoms, and about previous treatments. The immediate interaction with the interviewer during the dialogue was also described by using SASB. On the basis of only the first patients' utterances after the initial request of the therapists (like "What brings you here?") we can distinguish female and male patients by the quality of the relations described (to the symptoms, the previous physicians, and to the therapist). The sex-specific readiness to establish relationships which becomes apparent in these descriptions can be related to the interview situation itself. In our further argumentation we interpret them as subtle messages to the interviewer. Finally we discuss their inherent potentials and risks for the psychotherapeutic cooperation. PMID:1561845

  17. Patients' Perspectives on Wait Times and the Referral-Consultation Process While Attending a Tertiary Diabetes and Endocrinology Centre: Is Econsultation an Acceptable Option?

    PubMed

    Keely, Erin; Traczyk, Lara; Liddy, Clare

    2015-08-01

    The goal of this study was to establish patients' perspectives on the acceptability of wait times, the impact of wait times on their health and the possibility of using electronic consultations (eConsultations) to avoid visits to specialists. A 2-stage patient survey (self-administered and with a follow-up telephone call) and a chart audit was conducted on a sequential sample of patients attending their initial consultations in a tertiary diabetes and endocrinology centre. Patients' perspectives on actual and ideal wait times, the impact of waiting for access, the effectiveness of the referral-consultation process and attitudes toward eConsultations as an alternative to traditional referral-consultations were collected. The study involved 101 patients (22% for diabetes, 78% for endocrinologic conditions), whose comments were collated and categorized. Of the 101 patients who completed the survey, 61 also completed telephone interviews. The average wait time was 19 weeks; the median 10 weeks. More than 30% of patients waited longer than 6 months and 6% waited longer than 1 year. Overall, 90% of patients thought that the maximum wait time should be less than 3 months. While waiting, 58% of patients worried about a serious undiagnosed disease, 30% found their symptoms had affected their daily activities and 24% had to miss work or school due to symptoms. Of the patients, 46% considered eConsultation a viable alternative to face-to-face visits. Excessive wait times for specialist care remain barriers and have negative impacts on patients. Wait times significantly exceeded times patients considered acceptable. eConsultations provide acceptable alternatives for many patients, and they reduced the number of patients requiring traditional consultations. PMID:25797111

  18. Intranasal Oxytocin Administration Dampens Amygdala Reactivity towards Emotional Faces in Male and Female PTSD Patients.

    PubMed

    Koch, Saskia Bj; van Zuiden, Mirjam; Nawijn, Laura; Frijling, Jessie L; Veltman, Dick J; Olff, Miranda

    2016-05-01

    Post-traumatic stress disorder (PTSD) is a disabling psychiatric disorder. As a substantial part of PTSD patients responds poorly to currently available psychotherapies, pharmacological interventions boosting treatment response are needed. Because of its anxiolytic and pro-social properties, the neuropeptide oxytocin (OT) has been proposed as promising strategy for treatment augmentation in PTSD. As a first step to investigate the therapeutic potential of OT in PTSD, we conducted a double-blind, placebo-controlled, cross-over functional MRI study examining OT administration effects (40 IU) on amygdala reactivity toward emotional faces in unmedicated male and female police officers with (n=37, 21 males) and without (n=40, 20 males) PTSD. Trauma-exposed controls were matched to PTSD patients based on age, sex, years of service and educational level. Under placebo, the expected valence-dependent amygdala reactivity (ie, greater activity toward fearful-angry faces compared with happy-neutral faces) was absent in PTSD patients. OT administration dampened amygdala reactivity toward all emotional faces in male and female PTSD patients, but enhanced amygdala reactivity in healthy male and female trauma-exposed controls, independent of sex and stimulus valence. In PTSD patients, greater anxiety prior to scanning and amygdala reactivity during the placebo session were associated with greater reduction of amygdala reactivity after OT administration. Taken together, our results indicate presumably beneficial neurobiological effects of OT administration in male and female PTSD patients. Future studies should investigate OT administration in clinical settings to fully appreciate its therapeutic potential. PMID:26404844

  19. Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris

    PubMed Central

    Kim, Grace K.

    2012-01-01

    Oral spironolactone has been used for over two decades in the dermatological setting. Although it is not generally considered a primary option in the management of female patients with acne vulgaris, the increase in office visits by post-teenage women with acne vulgaris has recently placed a spotlight on the use of this agent in this subgroup of patients. This article reviews the literature focusing on the use of oral spironolactone in this subset of women with acne vulgaris, including discussions of the recommended starting dose, expected response time, adjustments in therapy, potential adverse effects, and patient monitoring. PMID:22468178

  20. Knowledge of symptoms and self-management of hypoglycaemia amongst patients attending a diabetic clinic at a regional hospital in KwaZulu-Natal

    PubMed Central

    John Ross, Andrew; Naidoo, Keshena

    2016-01-01

    Background Diabetic patients on insulin and sulphonylureas are at risk of developing hypoglycaemia. Many patients do not respond appropriately because of poor knowledge and understanding of the symptoms of hypoglycaemia, which if not promptly treated can lead to permanent neurological and renal damage. Hypoglycaemic complications can be avoided if patients have a good knowledge of the early symptoms of hypoglycaemia and know how to respond appropriately. Aim The aim of this study was to assess the knowledge of adult diabetic patients attending a diabetic clinic about symptoms of hypoglycaemia and how they responded to these symptoms. Setting A hospital-based diabetic clinic in northern KwaZulu-Natal. Methods This was a cross-sectional, descriptive study involving 200 diabetic patients. Demographic data and details of current medication, knowledge of hypoglycaemia and how patients responded to the symptoms were collected using a validated questionnaire. Results The majority of the patients had fair to good knowledge of hypoglycaemia; however, less than 25% knew what action to take when they experienced symptoms suggestive of hypoglycaemia. Conclusion There is a need to improve the education given to diabetic patients on stepwise measures to take to avoid life-threatening complications associated with hypoglycaemia. PMID:27380786

  1. A Case of Behcet’s Disease Combined with Pulmonary Artery Aneurysm in a Korean Female Patient

    PubMed Central

    Uh, Sootaek; Kim, Jin Oh; You, Yong Kyu; Moon, Seung Hyug; Park, Choon Sik

    1994-01-01

    Behcet’s disease (BD) is a systemic disorder of unknown process resulting from systemic vasculitis. The pulmonary involvements in BD are uncommon. Furthermore, in the female, involvement of the pulmonary artery is quite rare. There were a few cases of female patients with BD with pulmonary artery aneurysm confirmed by pulmonary artery angiogram. In this article, we report a case of BD, combined with pulmonary artery aneurysm, confirmed by pulmonary angiogram and treated by surgery in a Korean female patient. PMID:8038147

  2. Quality of Life and Migraine Disability among Female Migraine Patients in a Tertiary Hospital in Malaysia

    PubMed Central

    Shaik, Munvar Miya; Hassan, Norul Badriah; Gan, Siew Hua

    2015-01-01

    Background. Disability caused by migraine may be one of the main causes of burden contributing to poor quality of life (QOL) among migraine patients. Thus, this study aimed to measure QOL among migraine sufferers in comparison with healthy controls. Methods. Female diagnosed migraine patients (n= 100) and healthy controls (n=100) completed the Malay version of the World Health Organization QOL Brief (WHOQOL-BREF) questionnaire. Only migraine patients completed the Malay version of the Migraine Disability Assessment questionnaire. Results. Females with migraines had significantly lower total WHOQOL-BREF scores (84.3) than did healthy controls (91.9, P<0.001). Similarly, physical health (23.4 versus 27.7, P<0.001) and psychological health scores (21.7 versus 23.2, P< 0.001) were significantly lower than those for healthy controls. Seventy-three percent of patients experienced severe disability, with significantly higher number of days with headaches (13.8 days/3 months, P< 0.001) and pain scores (7.4, P< 0.013). Furthermore, migraine patients with lower total QOL scores had 1.2 times higher odds of having disability than patients with higher total QOL scores. Conclusions. The present study showed that migraine sufferers experienced significantly lower QOL than the control group from a similar population. Disability was severe and frequent and was associated with lower QOL among the migraine patients. PMID:25632394

  3. Sexual harassment of female physicians by patients. What is to be done?

    PubMed Central

    Phillips, S.

    1996-01-01

    OBJECTIVE: To determine the responses of female physicians who have been sexually harassed by patients, as a means of answering the question, "What is to be done?" DESIGN: As part of a larger study on the topic, randomly selected participants were mailed a questionnaire requesting information about the nature and extent of sexual harassment by patients and about resulting feelings, actions, and suggestions for prevention. SETTING: Family practices in Ontario. PARTICIPANTS: A random sample of the 1064 female certificants of the College of Family Physicians of Canada in active practice in Ontario during 1992 was selected. A total of 599 were surveyed; 422 (70%) replied. MAIN OUTCOME MEASURES: Responses to survey questions. RESULTS: Of the 422 respondents, 76% reported sexual harassment by patients and their reactions to it. Though most respondents had many suggestions about how to minimize harassment, written comments suggested confusion as to its cause. Many participants wondered whether their behaviour, manner, or dress provoked unwanted responses. The ability to root the cause of the harassment externally as a social rather than a personal problem seemed to decrease immobilization. CONCLUSIONS: There is no single effective response to sexual harassment, but understanding its source as an abuse of the power of gender* (perhaps to overcome the powerlessness felt as a patient) could enable female physicians to act in protective and effective ways. PMID:8924816

  4. Exercise increases serum endostatin levels in female and male patients with diabetes and controls

    PubMed Central

    2014-01-01

    Background Type 2 diabetes mellitus (T2DM) is often associated with atherosclerotic changes in coronary vessels, most notably plaques. The angiostatic parameter endostatin is able to inhibit angiogenesis in tissue as well as in plaques and therefore plays an important role in physiological and pathological neovascularisation. The aim of the present study was to investigate sex-specific differences and the influence of exercise on circulating endostatin levels in patients suffering from diabetes, and control subjects. Methods In total, 42 T2DM-patients and 45 control subjects were investigated. They underwent a graded physical stress test (ergometry). Serum endostatin levels were measured in venous blood at rest and directly after reaching maximum workload. Results Females showed significantly higher endostatin levels at baseline measurements compared to men, independently of their underlying disease. In both female and male T2DM-patients endostatin levels were significantly lower compared to controls. Both groups and sexes showed a significant increase of endostatin after physical stress, whereas the extent of endostatin-increase was between 10.59-15.05%. Conclusion Middle-aged healthy female individuals as well as female T2DM-patients showed higher circulating serum endostatin levels compared to males, suggesting a hormonal influence on baseline circulating endostatin amounts. Exercise-induced increase in endostatin is also observable in patients suffering from T2DM. Concerning vascularisation, lower endostatin levels in T2DM might be advantageous. Concerning plaque stability, lower levels might be prejudicial. Trial registration Clinical Trial Registration-URL: http://clinicaltrials.gov/ct2/results?term=NCT01165515 PMID:24393402

  5. Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers.

    PubMed

    Noël, Polly H; Parchman, Michael L; Finley, Erin P; Wang, Chen-Pin; Bollinger, Mary; Espinoza, Sara E; Hazuda, Helen P

    2016-12-01

    The Institute of Medicine (IOM) suggests that primary care-public health integration can improve health outcomes for vulnerable patients, but the extent to which formal linkages may enhance patients' use of community resources, or the factors that may influence providers to encourage their patients to use these resources, remain unclear. We conducted baseline assessments in 2014-2015 with 149 older adults with prediabetes or diabetes who had recently joined three senior centers linked to a network of primary care clinics in San Antonio, Texas. In addition to collecting sociodemographic and clinical characteristics, we asked members to identify their source of primary care and whether a health care provider had encouraged them to go to the senior center. We also asked members why they had joined the senior centers and which programs interested them the most. Members' source of primary care was not associated with being encouraged to attend the senior centers by a health care professional. Multivariable analysis indicated that participants with total annual household incomes of $20,000 or less [OR = 2.78; 95% CI = (1.05, 7.14)] and those reporting 12 years of education or less [OR = 3.57; 95% CI = (1.11, 11.11)] were significantly more likely to report being encouraged to attend the senior center by a health care provider. Providers who are aware of community-based resources to support patient self-management may be just as likely to encourage their socioeconomically vulnerable patients with prediabetes or diabetes to use them as providers who have a more formal partnership with the senior centers. PMID:27462529

  6. FISH analysis of a subtle familial Xp deletion in a female patient with Madelung deformity

    SciTech Connect

    Hsu, T.Y.; Gibson, L.H.; Pober, B.R.

    1994-09-01

    A subtle deletion of Xp [del(X)(p22.32)]was identified by high-resolution chromosome analysis in a twelve-year-old female with short stature (<2 percentile) and Madelung deformity suggestive of Turner syndrome. The proband`s mother, who has short stature (<2 percentile) and demyelinating disorder, also showed this deletion. The maternal grandmother is of normal height and carries two normal X chromosomes. Both the patient and her mother have no other physical abnormalities and are of normal intelligence. To confirm and delineate this Xp deletion, fluorescence in situ hybridization (FISH) was performed on metaphases from the patient and her mother using probes of DXYS20 (a pseudoautosomal locus), DXS232A, and a newly isolated Xp YAC clone, YHX2, whose relative map position is unknown. Hybridization signals of DXS232A were detected on both X chromosomes, and DXYS20 and YHX2 were missing from one of the X`s of both the patient and her mother. YHX2 was thus placed distal to DXS232A (tel-DXYS20-YHX2-S232A-cen). This familial deletion with a breakpoint distal to DXS232A, which is located at -900 Kb telomeric to STS locus, appears to be the smallest Xp deletion reported thus far. Short stature is consistently associated with females carrying Xp deletions. Madelung deformity has been found in some patients with Turner syndrome or Dyschondrosteosis but it has not been reported in patients with Xp deletion. Our results suggest that the phenotype of our patient is associated with her chromosome abnormality. Due to the subtlety of the deletion identified in our patient and her mother, females presenting with short stature warrant careful clinical and cytogenetic evaluation.

  7. Prolactin levels and autoantibodies in female patients with systemic lupus erythematosus.

    PubMed

    Kozáková, D; Rovenský, J; Cebecauer, L; Bosák, V; Jahnová, E; Vigas, M

    2000-01-01

    We investigated the relationships between prolactin (PRL) levels and antibody occurrence in systemic lupus erythematosus (SLE). No significant association between PRL levels and the majority of the autoantibodies studied (anti-U1 RNP, anti-rRNP, anti-Sm, anti-dsDNA, anti-DNP, auto-LCA, anti-EACA) could be confirmed (P > 0.05), anti-Ro/SSA antibodies being an exception. Our results showed significantly increased frequencies of these antibodies in the group of female SLE patients with normal PRL levels (< 20 micrograms/L): anti Ro/SSA in 53% (P < 0.025, chi 2 = 5.80, RR = 4.0) and anti-Ro/SSA + anti-Ro/La in 60% (P < 0.05, chi 2 = 4.05) compared with female SLE patients with hyperprolactinemia. PMID:11155810

  8. Late-onset epileptic spasms in a female patient with a CASK mutation.

    PubMed

    Nakajiri, Tomoshi; Kobayashi, Katsuhiro; Okamoto, Nobuhiko; Oka, Makio; Miya, Fuyuki; Kosaki, Kenjiro; Yoshinaga, Harumi

    2015-10-01

    We report a female patient with late-onset epileptic spasms (ESs) of a rare form, distinct from those seen in typical West syndrome, in association with a heterozygous frameshift CASK mutation (c.1896dupC (p.C633fs(∗)2)). She has a phenotype of microcephaly with pontine and cerebellar hypoplasia (MICPCH), and has had intractable ESs in clusters since 3 years 8 months of age with multifocal, particularly bifrontal, epileptic discharges in electroencephalogram. The available literature on patients with both ESs and CASK mutations has been reviewed, revealing that four of the five female children, including the present girl, had late-onset ESs, in contrast to the four males, who tended toward early-onset ESs. PMID:25765806

  9. HAE update: special considerations in the female patient with hereditary angioedema.

    PubMed

    Geng, Bob; Riedl, Marc A

    2013-01-01

    This review on hereditary angioedema (HAE) focuses on special topics regarding HAE in female patients. HAE is a bradykinin-mediated disorder, and the role of hormonal regulation of disease expression will be discussed focusing on the effect of estrogen on disease mechanism. The impact of exogenous estrogen on symptom exacerbation leads to special consideration regarding choice of contraceptives and safety of hormone replacement therapy. The effects of pregnancy and childbirth will be examined on the course of disease control. Unique considerations regarding therapeutic management for female HAE patients will be addressed, including the role of C1 inhibitor (C1-INH), ecallantide, and icatibant. Finally, this review will provide an overview of the more recently characterized HAE with normal C1-INH (HAE type III) that predominantly affects women and is in some cases associated with factor XII gene mutations. PMID:23406930

  10. Preoperative Factors Predicting Intraoperative Blood Loss in Female Patients With Adolescent Idiopathic Scoliosis

    PubMed Central

    Li, Chao; Yang, Mingyuan; Wang, Chao; Wang, Chuanfeng; Fan, Jianping; Chen, Ziqiang; Wei, Xianzhao; Zhang, Guoyou; Bai, Yushu; Zhu, Xiaodong; Xie, Yang; Li, Ming

    2015-01-01

    Abstract In this article, a retrospective analysis of 161 female patients with adolescent idiopathic scoliosis (AIS) is performed who underwent posterior correction and fusion using all-pedicle screw instrument. The aim of this article is to find out preoperative factors that influence intraoperative blood loss (IOBL) in female patients with AIS. The IOBL in posterior correction and fusion surgery for patients with idiopathic scoliosis greatly varies. The variables affecting the IOBL also greatly vary among different studies. Medical records of all female patients with AIS who underwent posterior correction and fusion operations using the all-pedicle screw system in our hospital from January 2012 to January 2014 were reviewed. Patients with irregular menstruation, who underwent osteotomy, and using coagulants were excluded. Preoperative clinical data, including patient age, height, weight, Risser sign, day after last menstruation, major curve Cobb angle, fulcrum-bending Cobb angle, curve flexibility index, sagittal thoracic Cobb angle, sagittal lumbar Cobb angle, albumin, hemoglobin, platelet, activated partial thromboplastic time (APTT), prothrombin time, thrombin time, fibrinogen, fusion level, menstrual phase, and blood type, were collected. Data were further analyzed using multiple linear regression with forward elimination. A total of 161 patients were included in this study. The mean IOBL was 933.98 ± 158.10 mL (500–2000 mL). Forward selection showed that fulcrum-bending Cobb angle, fusion level, Risser sign, APTT, fibrinogen, and menstrual phase were the preoperative factors that influenced the IOBL in female patients with AIS. Equation of IOBL was built by multiple linear regression: IOBL = −966.228 + 54.738 Risser sign + 18.910 fulcrum-bending Cobb angle + 114.737 fibrinogen + 21.386 APTT − 71.312 team 2 − 177.985 team 3 − 165.082 team 4 + 53.470 fusion level. R = 0.782. Operation for patients with AIS was featured by large IOBL

  11. Association of Pulmonary Cysts and Nodules in a Young Female Patient.

    PubMed

    Dias, Olívia Meira; do Nascimento, Ellen Caroline Toledo; Carvalho, Carlos Roberto Ribeiro; Araujo, Mariana Sponholz; Freitas, Carolina Salim Gonçalves; Kairalla, Ronaldo Adib; Dolhnikoff, Marisa; Baldi, Bruno Guedes

    2016-06-01

    A 27-year-old female patient was referred to our outpatient clinic with a 1-year history of shortness of breath when walking fast on level ground or when climbing stairs. Symptoms worsened after a second episode of spontaneous left pneumothorax, when a chest tube was placed in another hospital for complete lung expansion. During this hospitalization, an open lung biopsy was performed. There was no history of rhinorrhea, nasal congestion, cough, hemoptysis, wheezing, or expectoration. PMID:27287595

  12. Occurrence of epidermolysis bullosa along with Amelogenesis imperfecta in female patient of India

    PubMed Central

    Javed, A. P.; Shenai, Prashanth; Chatra, Laxmikanth; Veena, K. M.; Rao, Prasanna Kumar; Prabhu, Rachana

    2013-01-01

    Epidermolysis bullosa (EB) is an inherited disorder, which is characteristically presented as skin blisters developing in response to minor injury. Junctional variety of EB is also associated with enamel hypoplasia. Amelogenesis imperfecta presents with abnormal formation of the enamel both in deciduous and permanent dentition. This article describes a previously unreported case of Amelogenesis imperfecta with complete loss of enamel in a young female patient with EB. PMID:24379873

  13. [Multiple smooth colon stenosis in 76-year-old female patient].

    PubMed

    Muehlenberg, K; Dietl, O; Piso, P; Pech, O

    2015-10-01

    Differential diagnostic aspects of colon stenoses are discussed using the example case of a female patient presenting with multilocular colon metastases, who had lobular breast cancer 9 years previously. Typical is linitis plastica, which can indicate tumorous infiltration not only of the stomach, but also of the large intestine. Other endoscopic imaging and histological studies may, however, fail. The pathologist requires the anamnestic data relating to the breast cancer for exact assignment of the tumorous infiltration. PMID:26349909

  14. Pseudomonas aeruginosa Acquisition in Cystic Fibrosis Patients in Context of Otorhinolaryngological Surgery or Dentist Attendance: Case Series and Discussion of Preventive Concepts.

    PubMed

    Mainz, Jochen G; Gerber, Andrea; Lorenz, Michael; Michl, Ruth; Hentschel, Julia; Nader, Anika; Beck, James F; Pletz, Mathias W; Mueller, Andreas H

    2015-01-01

    Introduction. P. aeruginosa is the primary cause for pulmonary destruction and premature death in cystic fibrosis (CF). Therefore, prevention of airway colonization with the pathogen, ubiquitously present in water, is essential. Infection of CF patients with P. aeruginosa after dentist treatment was proven and dental unit waterlines were identified as source, suggesting prophylactic measures. For their almost regular sinonasal involvement, CF patients often require otorhinolaryngological (ORL) attendance. Despite some fields around ORL-procedures with comparable risk for acquisition of P. aeruginosa, such CF cases have not yet been reported. We present four CF patients, who primarily acquired P. aeruginosa around ORL surgery, and one around dentist treatment. Additionally, we discuss risks and preventive strategies for CF patients undergoing ORL-treatment. Perils include contact to pathogen-carriers in waiting rooms, instrumentation, suction, drilling, and flushing fluid, when droplets containing pathogens can be nebulized. Postsurgery mucosal damage and debridement impair sinonasal mucociliary clearance, facilitating pathogen proliferation and infestation. Therefore, sinonasal surgery and dentist treatment of CF patients without chronic P. aeruginosa colonization must be linked to repeated microbiological assessment. Further studies must elaborate whether all CF patients undergoing ORL-surgery require antipseudomonal prophylaxis, including nasal lavages containing antibiotics. Altogether, this underestimated risk requires structured prevention protocols. PMID:25866686

  15. Pseudomonas aeruginosa Acquisition in Cystic Fibrosis Patients in Context of Otorhinolaryngological Surgery or Dentist Attendance: Case Series and Discussion of Preventive Concepts

    PubMed Central

    Mainz, Jochen G.; Gerber, Andrea; Lorenz, Michael; Michl, Ruth; Hentschel, Julia; Nader, Anika; Beck, James F.; Pletz, Mathias W.; Mueller, Andreas H.

    2015-01-01

    Introduction. P. aeruginosa is the primary cause for pulmonary destruction and premature death in cystic fibrosis (CF). Therefore, prevention of airway colonization with the pathogen, ubiquitously present in water, is essential. Infection of CF patients with P. aeruginosa after dentist treatment was proven and dental unit waterlines were identified as source, suggesting prophylactic measures. For their almost regular sinonasal involvement, CF patients often require otorhinolaryngological (ORL) attendance. Despite some fields around ORL-procedures with comparable risk for acquisition of P. aeruginosa, such CF cases have not yet been reported. We present four CF patients, who primarily acquired P. aeruginosa around ORL surgery, and one around dentist treatment. Additionally, we discuss risks and preventive strategies for CF patients undergoing ORL-treatment. Perils include contact to pathogen-carriers in waiting rooms, instrumentation, suction, drilling, and flushing fluid, when droplets containing pathogens can be nebulized. Postsurgery mucosal damage and debridement impair sinonasal mucociliary clearance, facilitating pathogen proliferation and infestation. Therefore, sinonasal surgery and dentist treatment of CF patients without chronic P. aeruginosa colonization must be linked to repeated microbiological assessment. Further studies must elaborate whether all CF patients undergoing ORL-surgery require antipseudomonal prophylaxis, including nasal lavages containing antibiotics. Altogether, this underestimated risk requires structured prevention protocols. PMID:25866686

  16. Shielding during x-ray examination of pediatric female patients with developmental dysplasia of the hip.

    PubMed

    Tsai, Yi-Shan; Liu, Yi-Sheng; Chuang, Ming-Tsung; Wang, Chien-Kuo; Lai, Cheng-Shih; Tsai, Hong-Ming; Lin, Chii-Jeng; Lu, Chia-Hsing

    2014-12-01

    Patients with developmental dysplasia of the hip (DDH) generally undergo multiple x-ray examinations of both hip joints. During these examinations, the gonads are completely exposed to radiation, unless shielded. Although many types and sizes of gonad shields exist, they often do not provide adequate protection because of size and placement issues; additionally, these shields are frequently omitted for female patients. Our aim was to assess gonad protection during x-ray examination that is provided by gonad shields designed for individual female patients with DDH.We retrospectively retrieved data from the Picture Archiving and Communication System database; pelvic plain x-ray films from 766 females, 18 years old or younger, were included in our analysis. Based on x-ray measurements of the anterior superior iliac spine, we developed a system of gonad shield design that depended on the distance between anterior superior iliac spine markers. We custom-made shields and then examined shielding rates and shielding accuracy before and after these new shields became available. Standard (general-purpose) shields were used before our custom design project was implemented. The shielding rate and shielding accuracy were, respectively, 14.5% and 8.4% before the project was implemented and 72.7% and 32.2% after it was implemented. A shield that is more anatomically correct and available in several different sizes may increase the likelihood of gonad protection during pelvic x-ray examinations. PMID:25325378

  17. Laparoscopic ovarian transposition prior to pelvic irradiation in a young female patient with advanced rectal cancer.

    PubMed

    Kihara, Kyoichi; Yamamoto, Seiichiro; Ohshiro, Taihei; Fujita, Shin

    2015-12-01

    In the report, we describe the first case of laparoscopic ovarian transposition prior to pelvic radio-chemo therapy in a young female patient with advanced rectal cancer in Japan. A 14-year-old female visited a hospital because of consistent diarrhea and melena. Colonoscopy examination showed a bulky tumor of the rectum, which was diagnosed as moderately to poorly differentiated adenocarcinoma. The diagnosis was cT3N2aM1a (due to lymph node in pelvic side wall), cStage IVA. In an attempt to improve local control and sphincter preservation, neoadjuvant concurrent radio-chemo therapy was planned. Considering that pelvic irradiation particularly in young female might cause ovarian failure, laparoscopic ovarian transposition was carried out prior to pelvic irradiation. Sequentially the patient underwent low anterior resection of the rectum and lymphadenectomy including pelvic side wall. The menstruation was maintained with delay for 6 months after adjuvant chemotherapy. There is no evidence of cancer recurrence at 3 years after the surgery.In premenopausal patients with rectal cancer undergoing pelvic irradiation, laparoscopic ovarian transposition is one of the choices to prevent ovarian failure. PMID:26943437

  18. The independent effects of child sexual abuse and impulsivity on lifetime suicide attempts among female patients.

    PubMed

    Daray, Federico M; Rojas, Sasha M; Bridges, Ana J; Badour, Christal L; Grendas, Leandro; Rodante, Demián; Puppo, Soledad; Rebok, Federico

    2016-08-01

    Child sexual abuse (CSA) is a causal agent in many negative adulthood outcomes, including the risk for life-threatening behaviors such as suicide ideation and suicide attempts. Traumatic events such as CSA may pose risk in the healthy development of cognitive and emotional functioning during childhood. In fact, high impulsivity, a risk factor for suicidal behavior, is characteristic of CSA victims. The current study aims to understand the relations among CSA, impulsivity, and frequency of lifetime suicide attempts among a female patient sample admitted for suicidal behavior. Participants included 177 female patients between the ages of 18 and 63 years admitted at two hospitals in Buenos Aires, Argentina. Number of previous suicide attempts and CSA were assessed via structured interviews, while impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). A model of structural equations was employed to evaluate the role of impulsivity in the relation between CSA and suicide attempts. CSA (β=.18, p<.05) and impulsivity (β=.24, p<.05) were associated with the number of previous suicide attempts. However, impulsivity was not significantly associated with CSA (β=.09, p>.05). CSA and impulsivity are independently associated with lifetime suicide attempts among female patients with recent suicidal behavior. PMID:27352091

  19. Adrenocortical response to low-dose ACTH test in female patients with rheumatoid arthritis.

    PubMed

    Radikova, Zofia; Rovensky, Jozef; Vlcek, Miroslav; Penesova, Adela; Kerlik, Jana; Vigas, Milan; Imrich, Richard

    2008-12-01

    Alterations in adrenal steroid production have been suggested in females with rheumatoid arthritis (RA). The aim of the present study was to assess adrenocortical function in RA females. We examined 11 female RA patients (RA: age 30 +/- 2 years, BMI 21.0 +/- 0.7 kg/m(2)) and 10 matched healthy controls (C: age 31 +/- 1 years, BMI 21.6 +/- 0.6 kg/m(2)). Low-dose adrenocorticotropic hormone (ACTH) test (i.v. bolus of 1 microg synthetic ACTH) was performed at 10.00 h with blood sampling every 15 min for 90 min. Cortisol, 17-OH-progesterone (17OHP), androstenedione (ASD), and dehydroepiandrosterone (DHEA) were assayed in plasma. Baseline cortisol levels were higher in RA patients (RA: 385 +/- 38 versus C: 229 +/- 28 nmol/L, P= 0.007). In both study groups, ACTH administration increased all the four steroids measured (P < 0.001). Cortisol response to ACTH administration was diminished in RA patients when compared to controls (Delta(max): 284 +/- 24 in RA versus 424 +/- 31 nmol/L in C, P= 0.002). ACTH-induced maximal rise in plasma DHEA was significantly lower in RA patients when compared to controls (Delta(max): 2.59 +/- 0.68 in RA versus 5.57 +/- 1.25 ng/mL in C, P= 0.015). No significant between-groups differences were found in responses of ASD or 17OHP. The molar ratio of ASD:cortisol was significantly lower (P < 0.05) in RA patients at base line, but did not differ during ACTH test. After ACTH bolus, the cortisol:17OHP ratio decreased significantly in the RA group (P < 0.001), whereas there was no change in the control group. The present results show decreased secretion of cortisol and DHEA in RA patients in response to ACTH, suggesting a subtle HPA hypofunction at the adrenocortical level. PMID:19120158

  20. Decreased functional connectivity density in pain-related brain regions of female migraine patients without aura.

    PubMed

    Gao, Qing; Xu, Fei; Jiang, Cui; Chen, Zhifeng; Chen, Huafu; Liao, Huaqiang; Zhao, Ling

    2016-02-01

    Migraine is one of the most prevalent neurological disorders which is suggested to be associated with dysfunctions of the central nervous system. The purpose of the present study was to detect the altered functional connectivity architecture in the large-scale network of the whole brain in migraine without aura (MWoA). Meanwhile, the brain functional hubs which are targeted by MWoA could be identified. A new voxel-based method named functional connectivity density (FCD) mapping was applied to resting-state functional magnetic resonance imaging data of 55 female MWoA patients and 44 age-matched female healthy controls (HC). Comparing to HC, MWoA patients showed abnormal short-range FCD values in bilateral hippocampus, bilateral insula, right amygdale, right anterior cingulate cortex, bilateral putamen, bilateral caudate nucleus and the prefrontal cortex. The results suggested decreased intraregional connectivity of these pain-related brain regions in female MWoA. In addition, short-range FCD values in left prefrontal cortex, putamen and caudate nucleus were significantly negatively correlated with duration of disease in MWoA group, implying the repeated migraine attacks over time may consistently affect the resting-state functional connectivity architecture of these brain hubs. Our findings revealed the dysfunction of brain hubs in female MWoA, and suggested the left prefrontal cortex, putamen and caudate nucleus served as sensitive neuroimaging markers for reflecting the disease duration of female MWoA. This may provide us new insights into the changes in the organization of the large-scale brain network in MWoA. PMID:26688226

  1. Effect of Leptin Replacement on PCSK9 in ob/ob Mice and Female Lipodystrophic Patients.

    PubMed

    Levenson, Amy E; Haas, Mary E; Miao, Ji; Brown, Rebecca J; de Ferranti, Sarah D; Muniyappa, Ranganath; Biddinger, Sudha B

    2016-04-01

    Leptin treatment has beneficial effects on plasma lipids in patients with lipodystrophy, but the underlying mechanism is unknown. Proprotein convertase subtilisin/kexin type 9 (PCSK9) decreases low-density lipoprotein (LDL) clearance, promotes hypercholesterolemia, and has recently emerged as a novel therapeutic target. To determine the effect of leptin on PCSK9, we treated male and female ob/ob mice with leptin for 4 days via sc osmotic pumps (∼24 μg/d). Leptin reduced body weight and food intake in all mice, but the effects of leptin on plasma PCSK9 and lipids differed markedly between the sexes. In male mice, leptin suppressed PCSK9 but had no effect on plasma triglycerides or cholesterol. In female mice, leptin suppressed plasma triglycerides and cholesterol but had no effect on plasma PCSK9. In parallel, we treated female lipodystrophic patients (8 females, ages 5-23 y) with sc metreleptin injections (∼4.4 mg/d) for 4-6 months. In this case, leptin reduced plasma PCSK9 by 26% (298 ± 109 vs 221 ± 102 ng/mL; n = 8; P = .008), and the change in PCSK9 was correlated with a decrease in LDL cholesterol (r(2) = 0.564, P = .03). In summary, in leptin-deficient ob/ob mice, the effects of leptin on PCSK9 and plasma lipids appeared to be independent of one another and strongly modified by sex. On the other hand, in lipodystrophic females, leptin treatment reduced plasma PCSK9 in parallel with LDL cholesterol. PMID:26824363

  2. Breast cancer in a male-to-female transsexual patient with a BRCA2 mutation.

    PubMed

    Corman, Vinciane; Potorac, Iulia; Manto, Florence; Dassy, Sarah; Segers, Karin; Thiry, Albert; Bours, Vincent; Daly, Adrian F; Beckers, Albert

    2016-05-01

    Breast cancer is rare in male patients. Certain predisposing factors, be they genetic (e.g., BRCA2 gene mutations) or hormonal (imbalance between estrogen and androgen levels), have been implicated in male breast cancer pathophysiology. Male-to-female (MtF) transsexualism is a condition that generally involves cross-sex hormone therapy. Anti-androgens and estrogens are used to mimic the female hormonal environment and induce the cross-sex secondary characteristics. In certain situations, the change in the hormonal milieu can be disadvantageous and favor the development of hormone-dependent pathologies, such as cancer. We report a case of a MtF transgender patient who developed breast cancer after 7 years of cross-sex hormonal therapy. The patient was found to be BRCA2 positive, and suffered recurrent disease. The patient was unaware of being a member of an established BRCA2 mutation-positive kindred. This represents the first case of a BRCA2 mutation predisposing to breast cancer in a MtF transgender patient. PMID:27000661

  3. Fertility preservation in female cancer patients: an emerging challenge for physicians.

    PubMed

    Caserta, D; Ralli, E; Matteucci, E; Marci, R; Moscarini, M

    2014-03-01

    Fertility preservation has become an issue of great importance in female cancer patients due to increasing survival rates and delayed childbearing. It is an emerging challenge for physicians, cause of several related issues (multidisciplinary approach, doctor-patient communication, ethical, religious and legal problems) and many unresolved questions. This review aims to update the latest literature data, summarizing the effects of cancer treatments on female fertility and the various options currently available to offer cancer patients the opportunity of future pregnancies. Many strategies exist for fertility preservation in young women and they should be assessed according to the patient's age, type of cancer, partner status and time available. Some techniques are well established, others are still experimental. The established methods include embryo cryopreservation, transposition of ovaries prior to radiation therapy, radiation shielding of gonads and conservative surgical approaches. The experimental methods include oocyte cryopreservation, in vitro maturation of oocytes, ovarian tissue cryopreservation and transplantation, and ovarian suppression. Improvement of these techniques as well as better characterization of their success rates and risks, await further investigation. Oocytes donation and gestational surrogacy represent the last options. Thus, the care of these patients is challenging, complex and requires a multidisciplinary approach. A close collaboration between Oncologists, Specialists in Reproductive Medicine, Gynecologic Oncologists and Endocrinologists is crucial for always offering the best possible option. PMID:24637474

  4. Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients

    PubMed Central

    Zhang, Shu; Jiang, Zhi-Wei; Wang, Gang; Feng, Xiao-Bo; Liu, Jiang; Zhao, Jian; Li, Jie-Shou

    2015-01-01

    AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction (TVSE) for gastric cancer patients. METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE. RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3 (range, 42-69) years, and the mean body mass index was 23.2 (range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224 (range, 200-298) min and 62.5 (range, 50-150) mL, respectively. The mean postoperative hospital stay was 3.6 (range, 3-5) d. The mean number of lymph nodes resected was 23.6 (range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected. CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients. PMID:26715817

  5. [Three Elderly Female Patients Who Experienced Self-Recovery during End-of-Life Care at Home].

    PubMed

    Ohara, Hiro; Sato, Mutsuko

    2015-12-01

    Recently, after completing hospital treatment, 3 elderly female patients were introduced to our home care department for end-of-life care at home. However, these patients recovered almost by themselves and now spend quiet days. From now on, women became the era they live alone in the statistics on the elderly. On the basis of these 3 cases, it is suggested that elderly female patients have the capacity to overcome conditions such as infectious diseases and digestive system disorders. PMID:26809415

  6. Increased hair testosterone but unaltered hair cortisol in female patients with borderline personality disorder.

    PubMed

    Dettenborn, Lucia; Kirschbaum, Clemens; Gao, Wei; Spitzer, Carsten; Roepke, Stefan; Otte, Christian; Wingenfeld, Katja

    2016-09-01

    A number of studies have reported on dysfunctions in steroid secretion, including altered cortisol and testosterone levels in borderline personality disorder (BDP) patients compared to healthy controls. The present study extends findings from blood and saliva studies to the cumulative measure of hair steroids. We investigated women with BPD (n=18) and age- and education-matched healthy women (n=17). We did not find differences between BPD patients and healthy women (p=0.40) concerning hair cortisol levels but increased hair testosterone levels among BPD patients compared to controls (p=0.03). These results remained when restricting the analyses to unmedicated patients. Our data indicate altered long-term testosterone but not cortisol levels in females with BPD. Future studies should address the possible impact of altered testosterone on medical illness processes including metabolic syndrome in this population. PMID:27290653

  7. Factitious proteinuria - the most dominant feature in a young female patient with Munchausen syndrome.

    PubMed

    Lela, Ivana Vuković; Karanović, Sandra; Matišić, Danica; Kuzmanić, Duško; C Orić, Marijana; Šimić, Mirjana; Jelaković, Bojan

    2013-02-01

    Munchausen syndrome is a factitious disorder with predominantly physical signs and symptoms, resulting from the patient's high motivation for assuming a sick role, without any external incentives or boundaries. We report the case of a young female patient with factitious proteinuria in the nephrotic range and a fairly eventful medical history. After performing many expensive and unnecessary investigations and procedures,the real origin of the proteinuria was determined;it was found to be caused by the patient carefully adding calibrated egg albumin to her urine samples. This discovery roused suspicions about multiple, non-corroborated conditions from her history (e.g., multiple miscarriages, breast cancer, and thyroid disorders).The diversity of diseases presented by a single Munchausen patient tends to be bizarre,and thus is a challenge for health care providers to diagnose the condition. Teamwork is therefore of the utmost necessity to diagnose Munchausen syndrome. PMID:23364208

  8. Patient perception of cervical screening among women living with human immuno-deficiency virus infection attending an antiretroviral therapy clinic in urban South Africa.

    PubMed

    Wake, R M; Rebe, K; Burch, V C

    2009-01-01

    This study aims to ascertain the perception of cervical screening practices among HIV-positive women attending an ART clinic in urban South Africa. It is a prospective cross-sectional study of 100 randomly selected patients using semi-structured interviews. Answers to fixed-response questions were recorded for statistical analysis and themes were identified from responses to open-ended questions. The study found that 59% of women surveyed reported ever having had a Papanicolau (Pap) smear and that 41% of these women had never been notified of the result. Many women surveyed lacked understanding of cervical screening; 78% had never heard of cervical cancer and around 40% had no correct knowledge about Pap smears. The findings suggest that cervical screening practices among HIV-positive women living in urban South Africa do not comply with the recommendations that are based on evidence of increased risk for this population. Systematic cervical screening programmes should be offered to HIV-positive women attending ART clinics in South Africa. PMID:19280495

  9. A Descriptive Analysis of HIV Prevalence, HIV Service Uptake, and HIV-Related Risk Behaviour among Patients Attending a Mental Health Clinic in Rural Malawi

    PubMed Central

    Lommerse, Kinke; Stewart, Robert C.; Chilimba, Queen; van den Akker, Thomas; Lund, Crick

    2013-01-01

    Background Human immunodeficiency virus (HIV) and mental illness are interlinked health problems; mental illness may pose a risk for contracting HIV and HIV-positive individuals are at higher risk of mental illness. However, in countries with high HIV prevalence, the main focus of HIV-related health programmes is usually on prevention and treatment of somatic complications of HIV, and mental illness is not given high priority. We examined HIV prevalence, uptake of HIV services, and HIV-related risk behaviour among people attending a mental health clinic in rural Malawi. Methodology Semi-structured interviews were performed with patients capable to consent (94%), and with those accompanied by a capable caregiver who consented. HIV counselling and testing was offered to participants. Findings Among 174 participants, we collected 162 HIV test results (91%). HIV prevalence was 14.8%. Women were three times as likely to be HIV-positive compared to men. Two-thirds of participants reported having been tested for HIV prior to this study. The uptake of HIV-services among HIV-positive patients was low: 35% did not use recommended prophylactic therapy and 44% of patients not receiving antiretroviral treatment (ART) had never been assessed for ART eligibility. The reported rate of sexual activity was 61%, and 9% of sexually active participants had multiple partners. Inconsistent condom use with stable (89%) and occasional (79%) sexual partners, and absence of knowledge of the HIV status of those partners (53%, 63%) indicate high levels of sexual risk behaviour. Conclusions HIV-prevalence among persons attending the clinic, particularly men, was lower than among the general population in a population survey. The rate of HIV testing was high, but there was low uptake of preventive measures and ART. This illustrates that HIV-positive individuals with mental illness or epilepsy constitute a vulnerable population. HIV programmes should include those with neuropsychiatric illness

  10. Potential prescription patterns and errors in elderly adult patients attending public primary health care centers in Mexico City

    PubMed Central

    Corona-Rojo, José Antonio; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Vázquez-Cervantes, Laura; Pérez-Montoya, Edilberto; Rubio-Poo, Consuelo

    2009-01-01

    Introduction Six out of every 10 elderly persons live in developing countries. Objective To analyze and assess the drug prescription patterns and errors in elderly outpatients attending public health care centers in Mexico City, Mexico. Materials and methods A descriptive and retrospective study was conducted in 2007. Fourteen hundred prescriptions were analyzed. Prescriptions of ambulatory adults aged >70 years who were residents of Mexico City for at least two years were included. Prescription errors were divided into two groups: (1) administrative and legal, and (2) pharmacotherapeutic. In group 2, we analyzed drug dose strength, administration route, frequency of drug administration, treatment length, potential drug–drug interactions, and contraindications. Variables were classified as correct or incorrect based on clinical literature. Variables for each drug were dichotomized as correct (0) or incorrect (1). A Prescription Index (PI) was calculated by considering each drug on the prescription. SPSS statistical software was used to process the collected data (95% confidence interval; p <0.05). Results The drug prescription pattern in elderly outpatients shows that 12 drugs account for 70.72% (2880) of prescribed drugs. The most prescribed drugs presented potential pharmacotherapeutic errors (as defined in the present study). Acetylsalicylic acid–captopril was the most common potential interaction (not clinically assessed). Potential prescription error was high (53% of total prescriptions). Most of the prescription errors were due to omissions of dosage, administration route, and length of treatment and may potentially cause harm to the elderly outpatients. Conclusions A high number of potential prescription errors were found, mainly due to omissions. The drug prescription pattern of the study population is mainly constituted by 12 drugs. The results indicate that prescription quality depends on the number of prescribed drugs per prescription (p < 0