Quality of life after tracheostomy was addressed by measuring its impact on well being and body image perceptions.
A controlled study in a laryngotracheal clinic of a tertiary referral center. Three ...groups were studied: 24 cannulated, 19 decannulated, and 20 noncannulated patients. They filled up 3 conventional questionnaires.
(1) Satisfaction-with-life scale: reduced scores were detected between cannulated and noncannulated patients. (2) Personality traits: neuroticism and extroversion: no differences were noted. (3) Body cathexis scale: both cannulated and decannulated patients scored less than noncannulated. In tracheostomy-specific issues, decannulated patients scored better than cannulated patients.
Reduced scores after tracheostomy indicate an overall diminished quality of life. These changes correlate with personality traits. Decannulated patients exhibited only slight improvement indicating an incomplete psychosocial recovery.
This is the first report on tracheostomy related quality of life in noncancer patients conducted with specific psychological questionnaires.
Relating to the patient with burns as being posttraumatic calls for specific guidelines in emotional therapy. But it seems that burn injury differs from other posttraumatic situations in that it ...confronts the patient with a much more complex situation, including not only the actual burn experience but also the ensuing difficult period of hospitalization and the subsequent renewed encounter with the social environment. That is why we see the patient with burns as suffering from a Continuous Traumatic Stress Disorder rather than from a Posttraumatic Stress Disorder. Although both disorders confront the patient with the same symptoms and with the experience of shattering the stimulus barrier and that of the basic assumptions, like the concept of self, invulnerability, and the world, they still differ in duration of the trauma. This calls for "dos and don'ts" as treatment principles at the time of the hospitalization, which help the patient's ability in coping with the continuous trauma.
This title offers quick, concrete strategies to help parents use everyday opportunities to create respectful, responsible, and resilient children between the ages of 18 months and 12 years - without ...screaming or nagging. With today's busy parents in mind, each chapter provides easy-to-implement action steps and examples of how to teach respect, responsibility, and resilience, plus ways to address tantrums and unacceptable behaviour while avoiding future conflicts.
BACKGROUND: Local and worldwide prenatal charts for estimated fetal weight and postnatal charts for head circumference are gender specific. However, prenatal head circumference nomograms are not ...gender customized. OBJECTIVE: This study aimed to create gender-customized curves to assess between-gender head circumference differences and to study the clinical significance of using such gender-customized curves. STUDY DESIGN: A single-center retrospective study was conducted between June 2012 and December 2020. Prenatal head circumference measurements were obtained from routine estimated fetal weight ultrasound scans. Postnatal head circumference measurement at birth and gender were retrieved from computerized neonatal files. Head circumference curves were created, and the normal range was defined for the male and female subpopulations. After applying gender-specific curves, we analyzed the outcome of cases classified as microcephaly and macrocephaly according to non–gender-customized curves, which were reclassified as normal according to gender-specific curves. For these cases, clinical information and postnatal long-term outcomes were retrieved from patients’ medical records. RESULTS: The cohort included 11,404 participants (6000 males and 5404 females). The curve for male head circumference was significantly higher than the female curve for all gestational weeks (P<.0001). Applying gender customized curves resulted in fewer cases of male fetuses defined as 2 standard deviations above the normal range and female fetuses defined as 2 standard deviations below of the normal range. Cases reclassified as normal head circumference after the application of gender-customized curves were not related to increased adverse postnatal outcomes. The rate of neurocognitive phenotypes was not higher than the expected rate in both male and female cohorts. Polyhydramnios and gestational diabetes mellitus were more common in the normalized male cohort, whereas oligohydramnios, fetal growth restriction, and cesarean delivery were more common in the normalized female cohort. CONCLUSION: Prenatal gender-customized curves for head circumference can reduce the overdiagnosis of microcephaly in females and macrocephaly in males. According to our results, gender-customized curves did not affect the clinical yield of prenatal measurements. Therefore, we suggest that gender-specific curves be used to avoid unnecessary workup and parental anxiety.
In this study, eight patients participated in a standardized protocol to assess the effects of caffeine on seizures in ECT. Caffeine sodium benzoate (500-2000 mg) was administered intravenously 10 ...minutes before ECT, and seizure duration was compared with that of a previous treatment unmodified by caffeine. Seizure duration was significantly increased during ECTs preceded by caffeine. Three other patients given caffeine when seizures of adequate duration could no longer be elicited at maximal stimulus levels experienced longer seizures. Administration of caffeine was not associated with significant cardiovascular or other (including cognitive) adverse effects.
Thirty-four women who had undergone breast reconstruction after mastectomy for breast cancer were evaluated as to their emotional and psychosocial adjustment. Standardized psychological tests and a ...self-report questionnaire were used, along with the surgeon's evaluation of the aesthetic success of the reconstruction. Two psychodiagnostic tests were found to be of use in identifying maladjusted women who do not gain optimal benefit from the reconstruction: a questionnaire that evaluates the level of depression (Beck) and another that assesses the level of optimism (Cantrill). No correlation was observed between the surgeon's evaluation of the reconstruction's aesthetic success and the women's satisfaction. It was found that there are two groups of emotional-high-risk women: single women and women receiving adjuvant therapy. It is suggested that emotional-high-risk patients be given psychological support concerning the importance of the mastectomy and their reaction to breast reconstruction.
Autohypnosis (that is performing hypnosis in the absence of the therapist) was used for adjuvant analgesic and anxiolytic therapy in 18 burn patients. It combines the advantages of hypnosis without ...being limited by the availability of the hypnotic therapist immediately prior to painful activities. Autohypnosis is less time and labour consuming, and therefore less expensive. Out of 180 patients treated with autogenic relaxation techniques only 48 (27 per cent) entered a state of hypnosis that enabled them to cope with their pain, and 18 (10 per cent) achieved autohypnosis. Most of these patients needed some auxiliary devices such as recorded instructions or telephone calls.
