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1/101. Implantation of patients with prelingual long-term deafness.

    The purpose of this paper is to provide performance data on long-term congenitally and prelingually deafened children and adults who are implanted with the CLARION Multi-Strategy Cochlear Implant and who use the Continuous Interleaved Sampler (CIS) speech processing strategy. Open-set speech perception was assessed preoperatively and postoperatively with word and sentence recognition tests. Results indicate that a majority of subjects showed improvement from preoperative performance to the last available postoperative evaluation. These results represent a change from previously reported data on a similar population who used earlier speech processing strategies.
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ranking = 1
keywords = perception
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2/101. Balloon endometrial ablation as a safe alternative to hysterectomy.

    Each year, 600,000 hysterectomies are performed in the united states, costing an estimated $4 billion. Approximately 50% of these hysterectomies are performed for menorrhagia or abnormal uterine bleeding. menorrhagia can have a negative impact on a woman's lifestyle and self-perception, often leading her to seek definitive treatment. Pharmacologic treatment for menorrhagia is not always successful, and dilatation and curettage provides relief for only the first few menstrual cycles. Surgical options include hysterectomy and two forms of endometrial ablation. Current research demonstrates that thermal uterine balloon therapy is the safest of these options. Uterine balloon therapy, an outpatient procedure, has resulted in successful reduction in menstrual flow in 70% to 90% of patients, and it soon may be performed as an office-based procedure.
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ranking = 2.2562140440559
keywords = research, perception
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3/101. A developmentally sensitive approach to clinical hypnosis for chronically and terminally ill adolescents.

    Adolescents who suffer from terminal and/or chronic medical illnesses must face difficult developmental issues coupled with increased burdens of physical discomfort and uncertainty about survival. Clinical hypnosis is one technique that can be used to help these individuals gain a sense of comfort and control over their lives. I describe the use of a developmentally sensitive hypnotherapeutic intervention for chronically and terminally ill adolescents. I have used the technique for the reduction of various types of physical and psychological discomfort secondary to a range of medical problems such as cancer, end-stage renal disease, organ transplant, and hiv disease. The treatment focuses on the use of personalized procedures that attempt to increase perceptions of control through interactive formats. movement through a personally intriguing journey is used as a metaphor for controlling and moving away from discomfort. I also present three case examples as well as general treatment recommendations for clinical use.
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keywords = perception
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4/101. Partnership in education: an example of client and educator collaboration.

    This article describes one education strategy designed to assist nursing staff in the process of "learning to surrender" the service providers' need to direct client decision-making. Using the health promotion principle of "client as expert," a nurse educator and a client with advanced multiple sclerosis co-present an inservice class about the importance of personal empowerment and environmental mastery for maintaining physical and psychological well-being in the face of a chronic disorder. This collaborative strategy provided the client a forum from which to share his personal experience and professional knowledge to influence attitudes and provide valuable information to nursing staff in a long-term care facility. Collaborating with the client to bring information to nursing staff is one means to foster a climate of client empowerment, influence staff perceptions and communicate the unique experiences of the client.
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ranking = 1
keywords = perception
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5/101. Impact of recurrent and chronic pain on child and family daily functioning: a critical review of the literature.

    The author reviewed the current status of research on the impact of recurrent and chronic pain on everyday functioning of children and families and organized the research findings around the specific life contexts (e.g., school, peers) that may be affected by pain. Although findings demonstrate that many different aspects of child and family life are affected by pain, the prevalence and severity of children's functional limitations associated with pain remain unknown. Few treatment studies for pediatric recurrent and chronic pain have focused on enhancing children's functioning. It has been shown, however, that functional outcomes can be improved by cognitive-behavioral interventions. Recommendations for research on functional outcomes and implications for clinical practice are discussed.
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ranking = 3.7686421321677
keywords = research
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6/101. A nursing practice model for chronic illness.

    As the 21st century approaches, one very important issue for nursing is the increased prevalence of chronic conditions such as arthritis. Self-management is one way that individuals can cope with the uncertainty and many changes chronic illness brings. The purpose of this article is to describe a nursing model that addresses the need for enhanced self-management skills and the rehabilitation nurse's role in this process. The model is based on the concept of intentional action and uses Orem's (1995) self-care deficit nursing theory as its conceptual structure. The expected outcomes of care for clients are effective self-management skills and subsequently improved health status and quality of life. The model will be useful in the design of rehabilitation nursing research as well as in the planning of care for individuals with chronic illness.
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ranking = 1.2562140440559
keywords = research
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7/101. Positron emission tomography study of a chronic pain patient successfully treated with somatosensory thalamic stimulation.

    Previous neuroimaging studies suggested that the neuronal network underlying the perception of chronic pain may differ from that underlying acute pain. To further map the neural network associated with chronic pain, we used positron emission tomography (PET) to determine significant regional cerebral blood flow (rCBF) changes in a patient with chronic facial pain. The patient is implanted with a chronic stimulation electrode in the left ventroposterior medial thalamic nucleus with which he can completely suppress his chronic pain. The patient was scanned in the following conditions: before thalamic stimulation (pain, no stimulation), during thalamic stimulation (no pain, stimulation) and after successful thalamic stimulation (no pain, no stimulation). Comparing baseline scans during pain with scans taken after stimulation, when the patient had become pain-free, revealed significant rCBF increases in the prefrontal (Brodmann areas (BA) 9, 10, 11 and 47) and anterior insular cortices, hypothalamus and periaqueductal gray associated with the presence of chronic pain. No significant rCBF changes occurred in thalamus, primary and secondary somatosensory cortex and anterior cingulate cortex, BA 24'. Significant rCBF decreases were observed in the substantia nigra/nucleus ruber and in the anterior pulvinar nucleus. During thalamic stimulation, blood flow significantly increased in the amygdala and anterior insular cortex. These data further support that there are important differences in the cerebral processing of acute and chronic pain.
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ranking = 1
keywords = perception
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8/101. Surgical management of pyoderma gangrenosum: case report and review.

    BACKGROUND: Commonly used treatments for pyoderma gangrenosum are medical, with immunosuppressive agents employed most often. OBJECTIVE: To report a case and discuss the indications for radical surgical treatment of pyoderma gangrenosum. methods: Analysis of a case of Crohn's disease-associated pyoderma gangrenosum treated with immunosuppression followed by amputation, and a review of the literature on surgical management of pyoderma gangrenosum. RESULTS: In unstable patients with intractable multiple medical problems, surgical treatment of pyoderma gangrenosum may be indicated by the existence of these life-threatening comorbidities. The recent literature suggests that surgical management of pyoderma gangrenosum may also be appropriate in other special circumstances. CONCLUSIONS: Surgical management, including amputation, may have a role in the management of pyoderma gangrenosum. Further research is needed to delineate precisely the circumstances and patient factors that are appropriate indications for such surgery.
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ranking = 1.2562140440559
keywords = research
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9/101. Persistent verrucous varicella as the initial manifestation of hiv infection.

    Clinical presentations of varicella-zoster virus (VZV) infection may vary widely among healthy and immunocompromised patients. In addition, the recurrence of VZV infection with cutaneous manifestations in both of these populations is more common than was once believed. Most cases of verrucous varicella infection have been reported in patients with documented immunosuppression (most commonly hiv/AIDS). We present an unusual case of persistent verrucous varicella, which was the initial manifestation of hiv infection, in a previously "healthy" 3-year-old girl with a strong family history of wiskott-aldrich syndrome. Current research, therapeutic options, and differential diagnoses with regard to VZV infection are briefly reviewed.
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ranking = 1.2562140440559
keywords = research
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10/101. Hereditary chronic pancreatitis: implications for surgical treatment and follow-up.

    Hereditary pancreatitis is an uncommon cause of chronic pancreatitis in Western society. It should be suspected when chronic pancreatitis presents in young adults. The diagnosis is made when chronic pancreatitis is present in several members of the same family who are determined not to have other risk factors for chronic pancreatitis. Molecular research focusing on mutations in the trypsinogen gene has uncovered the genetic defects associated with hereditary pancreatitis, and this knowledge has suggested the possible pathophysiologic mechanism of this disease. Because patients with hereditary pancreatitis develop their disease early in life they are very likely to require treatment for complications. As in patients with chronic pancreatitis of other etiologies those with hereditary pancreatitis should be treated medically for acute exacerbations. When complications occur or when the disease causes intractable pain surgery is recommended. Surgical therapy is tailored to the patient's pancreatic anatomy based on endoscopic retrograde cholangiopancreatography or CT scan. The two patients described in this report underwent successful longitudinal pancreaticojejunostomy (Puestow procedure) with good results. Finally it has been shown that patients with hereditary pancreatitis are at increased risk for developing pancreatic adenocarcinoma. Although not widely used pancreatic cancer screening programs have been suggested for surveillance of these patients.
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ranking = 1.2562140440559
keywords = research
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