Intervention In Patients Research Articles

Analisis Asuhan Keperawatan Melalui Intervensi Kompres Bawang Merah Pada A.n J dan An. N Dengan Febris

ABSTRACT
 A NURSING CARE ANALYSIS THROUGH A RED ONION COMPRESS INTERVENTION IN PATIENTS AN. J AND AN. N WITH FEBRIS (FEVER) MEDICAL DIAGNOSIS AT RT 02 KEMIRI MUKA VILLAGE, DEPOK CITY
 
 Background: Fever or febris is a condition where body temperature rises above normal. Fever is not a disease itself, but it is a symptom of an underlying condition that needs to be treated properly to minimize the negative impacts. One of non-pharmacological interventions to treat fever, such as applying red onion compress, can be used for children.
 Objective: To analyze nursing care through a red onion compress intervention in patients AN. J and AN. N diagnosed with febris in the Kemiri Muka Village area, Depok City.
 Implementation: The nursing care for both patients was carried out from July 20th-22nd 2023, and from July 24th-26th 2023. The implementation focused on nursing diagnosis of hyperthermia, with the goal of reducing fever in both patients through the application of red onion compress.
 Results: The nursing evaluation of the main problem, hyperthermia, showed that after appliying the red onion compress to both patients for 3 days, the data showed a decrease in body temperature on the 3rd day after the nursing intervention.
 Conclusion and Recommendation: Red onion compress therapy proved to be effective in reducing body temperature in children with a nursing problem of hyperthermia. It is hoped that patients and/or families can apply this nursing intervention by applying red onion compress on the other family members who experience fever in order to reduce their body temperature. However, it is also important to pay attention to skin reactions after applying the red onion compress.
 Keywords: Febris, Hyperthermia, Red Onion Compress Intervention.

Minimal clinically important difference of the Berg Balance Scale and comfortable walking speed in patients with acute stroke: A multicenter, prospective, longitudinal study

Objective To determine the minimal clinically important difference between the Berg Balance Scale and comfortable walking speed in acute-phase stroke patients. Design Multicenter, prospective, longitudinal study. Setting Inpatient acute stroke rehabilitation. Subjects Seventy-five patients with acute stroke, mean (SD) age 71.7 (12.2) years. Intervention Inpatients with acute stroke were assessed with the Berg Balance Scale and comfortable walking speed before and after rehabilitation. Physiotherapy was conducted to improve balance and gait over a 2-week period: an average of 40 min/day on weekdays and 20 min/day on weekends and holidays. Main measures The patients’ Berg Balance Scale, comfortable walking speed, Global Rating of Change scale (patient-rated and physiotherapist-rated), and motor score of the Functional Independence Measure were obtained. Minimal clinically important differences were estimated using both anchor- (receiver operating characteristic curves and change difference) and distribution-based approaches (minimal detectable change and 0.5× the change score [SD]). Results The baseline scores were 31.2 (18.9) for the Berg Balance Scale and 0.79 (0.35) m/s for comfortable walking speed. The minimal clinically important difference in the Berg Balance Scale was 6.5–12.5 points by the anchor-based approach and 2.3–4.9 points by the distribution-based approach. The minimal clinically important difference in comfortable walking speed was 0.18–0.25 m/s by the anchor-based and 0.13–0.15 m/s by the distribution-based approach. Conclusions A change of 6.5–12.5 points in the Berg Balance Scale and 0.18–0.25 m/s in the comfortable walking speed is required in these measurements’ anchor-based minimal clinically important differences to be beyond measurement error, and to be perceptible by both patients and clinicians.

Expectations and Concerns about the Use of Telemedicine for Autism Spectrum Disorder: A Cross-Sectional Survey of Parents and Healthcare Professionals.

Telemedicine has recently been used for diagnosis and interventions inpatients with autism spectrum disorder (ASD), traditionally performed in-person, but little attention has been paid to user expectations prior to its use. The aim of this study is to compare the expectations and concerns of 50 healthcare professionals and 45 parents of children with ASD regarding the use of telemedicine for diagnostic or treatment purposes. Parents have higher expectations for the use of telemedicine as an alternative (p = 0.0223) and supplement (p = 0.0061) to in-person diagnosis of ASD, as well as a supplement to traditional intervention (p ≤ 0.0001). In addition, while they also have greater hope for improvement in family routines (p = 0.0034) and parenting skills in child management (p = 0.0147), they express greater concern about the need for active parental involvement/supervision during telemedicine services (p = 0.015) and changes in the behaviour of the child with ASD during telemedicine services (p = 0.049). On the other hand, healthcare professionals are more concerned about barriers such as lack of devices (p = 0.000), unfamiliarity with the technology (p = 0.000), poor quality of internet connection (p = 0.006), and severity of ASD (p = 0.000). To achieve promising healthcare for ASD patients, the telemedicine service should try to meet the needs and preferences of both healthcare professionals and parents, as well as identify and, if possible, reduce perceived barriers.

Using Anger Management Virtual Reality Cognitive Behavior Therapy to Treat Violent Offenders with Alcohol Dependence in South Korea: A Preliminary Investigation

Cognitive Behavior Therapy (CBT) effectively treats impulse/anger attacks and aggressive-impulsive behaviors, frequently conducted concerning domestic violence, among patients with alcohol dependence. CBT combined with virtual reality (VR) is a new and beneficial psychotherapeutic intervention for patients and violent offenders with impulse-anger control problems and alcohol dependence. This clinical study evaluated the effects of the “anger management virtual reality cognitive behavior therapy (AM-VR-CBT)” and motivational interviewing (MI) intervention program on quantitative electroencephalography (QEEG) mapping patterns among violent offenders with alcohol dependence (N = 29) in the National Probation Service. A clinical sample of twenty-nine violent offenders with alcohol dependence, who were evaluated and diagnosed with destructive and impulse-control disorders (DICD), underwent AM-VR-CBT combined with MI. The sessions lasted 150 minutes (AM-VR-CBT: 90 min; MI: 60 min) and were conducted twice a week for three weeks (six sessions). The intervention outcomes were measured using advanced QEEG brain mapping and standardized neurocognitive, emotional, and behavioral inventories, including the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), the Readiness to Change Questionnaire (RTCQ), the Barratt Impulsiveness Scale-II (BIS-II), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-Second Edition (BDI-2), and the State-Trait Anger Expression Inventory-2 (STAXI-2), to identify neuro-psycho-physiological changes in violent offenders with alcohol dependence. The Wilcoxon signed-rank test was used at p < 0.05. The intervention showed significant improvements and healthy behavioral changes related to obsessive drinking thoughts, compulsive drinking behaviors, attentional control, intrinsic motivation, worry, anxiety, depression, impulse-anger control issues, aggressive behaviors, over-control, interpersonal relationships, self-efficacy, self-reflection, self-inhibition, creativity, mental navigation/imagery, and episodic memory retrieval among violent offenders with alcohol dependence. Therefore, the results demonstrate the efficacy of the novel and promising clinical evidence-based implementation of the AM-VR-CBT + MI program intervention for non-invasive neuromodulation and related neuro-psycho-physiological, neurocognitive, emotional, and behavioral changes among violent offenders demonstrating alcohol dependence, impulse-anger control, and aggressive behaviors.

In-Hospital Mortality Risk Factor Analysis in Multivessel Percutaneous Coronary Intervention Inpatient Recipients in the United States.

ObjectivesThe primary goal of our study is to evaluate the mortality rate in inpatient recipients of multivessel percutaneous coronary intervention (MVPCI) and to evaluate the demographic risk factors and medical complications that increase the risk of in-hospital mortality.MethodsWe conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS, 2016) and included 127,145 inpatients who received MVPCI as a primary procedure in United States' hospitals. We used a multivariable logistic regression model adjusted for demographic confounders to measure the odds ratio (OR) of association of medical complications and in-hospital mortality risk in MVPCI recipients.ResultsThe in-hospital mortality rate was 2% in MVPCI recipients and was seen majorly in older-age adults (>64 years, 74%) and males (61%). Even though the prevalence of mortality among females was comparatively low, yet in the regression model, they were at a higher risk for in-hospital mortality than males (OR 1.2; 95% CI 1.13-1.37). While comparing ethnicities, in-hospital mortality was prevalent in whites (79%) followed by blacks (9%) and Hispanics (7.5%). Patients who developed cardiogenic shock were at higher odds of in-hospital mortality (OR 9.2; 95% CI 8.27-10.24) followed by respiratory failure (OR 5.9; 95% CI 5.39-6.64) and ventricular fibrillation (OR 3.5; 95% CI 3.18-3.92).ConclusionAccelerated use of MVPCI made it important to study in-hospital mortality risk factors allowing us to devise strategies to improve the utilization and improve the quality of life of these at-risk patients. Despite its effectiveness and comparatively lower mortality profile, aggressive usage of MVPCI is restricted due to the periprocedural complications and morbidity profile of the patients.

Glucocorticoid Excess in Patients with Pheochromocytoma Compared with Paraganglioma and Other Forms of Hypertension.

ContextCatecholamines and adrenocortical steroids are important regulators of blood pressure. Bidirectional relationships between adrenal steroids and catecholamines have been established but whether this is relevant to patients with pheochromocytoma is unclear.ObjectiveThis study addresses the hypothesis that patients with pheochromocytoma and paraganglioma (PPGL) have altered steroid production compared with patients with primary hypertension.DesignMulticenter cross-sectional study.SettingTwelve European referral centers.PatientsSubjects included 182 patients with pheochromocytoma, 36 with paraganglioma and 270 patients with primary hypertension. Patients with primary aldosteronism (n = 461) and Cushing syndrome (n = 124) were included for additional comparisons.InterventionIn patients with PPGLs, surgical resection of tumors.Outcome measuresDifferences in mass spectrometry–based profiles of 15 adrenal steroids between groups and after surgical resection of PPGLs. Relationships of steroids to plasma and urinary metanephrines and urinary catecholamines.ResultsPatients with pheochromocytoma had higher (P < .05) circulating concentrations of cortisol, 11-deoxycortisol, 11-deoxycorticosterone, and corticosterone than patients with primary hypertension. Concentrations of cortisol, 11-deoxycortisol, and corticosterone were also higher (P < .05) in patients with pheochromocytoma than with paraganglioma. These steroids correlated positively with plasma and urinary metanephrines and catecholamines in patients with pheochromocytoma, but not paraganglioma. After adrenalectomy, there were significant decreases in cortisol, 11-deoxycortisol, corticosterone, 11-deoxycorticosterone, aldosterone, and 18-oxocortisol.ConclusionsThis is the first large study in patients with PPGLs that supports in a clinical setting the concept of adrenal cortical–medullary interactions involving an influence of catecholamines on adrenal steroids. These findings could have implications for the cardiovascular complications of PPGLs and the clinical management of patients with the tumors.

EXPERIENCE IN PERFORMING X-RAY SURGICAL INTERVENTIONS IN PATIENTS WITH MALIGNANT NEOPLASMS

This work presents our experience of performing various x-ray surgical interventions in patients with malignant neoplasm, treated in the Volgograd Regional Oncology Center over a period of time from November 2017 until May 2019. Overall 448 port systems were installed for patients undergoing systemic chemotherapy, we implanted 10 cava filters, 32 external drainage of the bile ducts, 9 external-internal drainage of the bile ducts to patients with tumors of the hepatopancreatoduodenal zone were performed. Also, methods of chemoembolization of unresectable focal liver lesions and preoperative embolization of the portal vein branches were introduced.

SURVIVAL AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH DEMENTIA

SURVIVAL AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH DEMENTIA

Effect of Listening to Preferred Music on Intensity of Pain and Physiologic Parameters in Patients Undergoing Coronary Artery Bypass Grafting Surgery

Background and Aim: Pain is common patient complaint after Coronary Artery Bypass Grafting (CABG) surgery. In present study, we examined the effect of listening to preferred music on intensity of pain and physiologic parameters in patients undergoing CABG surgery. Methods: In a randomized controlled clinical trial, 50 patients who were under CABG surgery were randomly assigned to group A (control group) or group B (intervention group). Patients in group “A” received usual care after surgery. In addition to usual care, patients in group “B” listened their preferred music (music played by MP4 player with special headphones for 30 minutes two time per day (10 am and 17 pm)). Patients’ pain and physiologic parameters (heart rate, respiratory rate, diastolic and systolic blood pressure) were measured with using Numerical Rating Scale (NRS) and standard apparatus immediately before and 30 minute after intervention. Results: The mean score of pain intensity before and after intervention in patients in group “B” was 4.18 ± 2.68 and 3.13 ± 2.55 respectively (p<0.05). The mean score of pain intensity before and after intervention in patients in group “A” was 5.16 ± 1.37 and 5.20 ± 1.38 respectively (p>0.05). Among physiologic parameters, heart rate and respiratory rate decreased significantly in patients in group “B” (P>0.05). Conclusion: Music is should be considered by clinicians as a non pharmacological, non invasive, simple, cheap, safe, and effective method for pain management after CABG surgery. Music also has not negative effect of patient’s physiologic parameters. Keywords: Pain, vital signs, cardiac surgery, music, non pharmacological methods

In-Bag Manual Extraction of Excised Myomas by Surgical Scalpel through Suprapubic Mini-Laparotomic Incision in Laparoscopic-Assisted Myomectomy

Study ObjectiveTo evaluate the safety and feasibility of in-bag manual extraction for the retrieval of excised myomas through a suprapubic mini-laparotomic incision in 2-port laparoscopic-assisted myomectomy. DesignRetrospective comparative study (Canadian Task Force classification II-2). SettingDepartments of obstetrics and gynecology and diagnostic pathology at a general hospital. PatientsTwenty-six patients undergoing open manual extraction and 26 patients undergoing in-bag manual extraction by surgical scalpel for the retrieval of excised myomas through a suprapubic mini-laparotomic incision in 2-port laparoscopic-assisted myomectomy. InterventionsIn patients with open manual extraction, myoma tissues were directly morcellated in an uncontained setting, whereas in patients managed by in-bag manual extraction, enucleated myomas were put into a retriever bag and then were morcellated by a surgical scalpel while monitoring bag damage by the leakage of indigo carmine dye filled in a bag. The patient demographics and surgical outcome measures were compared between the 2 groups. In the initial 15 patients with in-bag manual extraction, the macroscopic myoma fragments retained in the bag were collected and removed after completion of myoma extraction. Then, the bag contents were washed with normal saline and spilled microscopic tissues salvaged by centrifugation. A histologic examination was performed for collected tissue materials to identify the microscopic myoma fragments. Measurements and Main ResultsIn patient demographics and surgical outcomes, which include excised tissue weight, surgical duration, and estimated intraoperative blood loss, no significant differences could be identified between the 2 groups. Bag rupture as monitored by the leakage of indigo carmine dye in vivo and ex vivo was not observed. In all patients managed by in-bag manual extraction, spilled macroscopic myoma fragments were identified in the bag. Furthermore, histologic examinations of collected bag contents detected microscopic myoma tissues in 53.3% of patients. These results suggest that without closed conditions, these microscopic myoma particles, which could be difficult to completely remove even by rigorous washing of the peritoneal cavity under laparoscopic vision, might be dispersed in the peritoneal cavity and potentially form iatrogenic peritoneal parasitic myomas if they survive and grow. ConclusionIn-bag manual extraction of myoma tissues through a suprapubic mini-laparotomic incision by a surgical scalpel is a feasible alternative to prevent the dispersion of microscopic myoma fragments and to avoid the potential risk of spreading occult malignancy in 2-port laparoscopic-assisted myomectomy.

관상동맥중재술 환자의 재원일수 중증도 보정 모형 개발

Our study was carried out to develop the severity-adjustment model for length of stay in hospital for percutaneous coronary interventions so that we would analysis the factors on the variation in length of stay(LOS). The subjects were 1,011 percutaneous coronary interventions inpatients of the Korean National Hospital Discharge In-depth Injury Survey 2004-2006 data. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for percutaneous coronary interventions. There was variation of LOS in regional differences, size of sickbed and insurance type. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

S654 EARLY MULTIMODAL INTERVENTION IN PATIENTS WITH ACUTE WHIPLASH-ASSOCIATED DISORDERS (WAD)

S654 EARLY MULTIMODAL INTERVENTION IN PATIENTS WITH ACUTE WHIPLASH-ASSOCIATED DISORDERS (WAD)

Issue Highlights

HomeCirculationVol. 113, No. 2Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published17 Jan 2006https://doi.org/10.1161/circ.113.2.177Circulation. 2006;113:177LONG-TERM ADHERENCE TO EVIDENCE-BASED SECONDARY PREVENTION THERAPIES IN CORONARY ARTERY DISEASE, by Newby et al.Many studies have focused on the underuse of various secondary prevention treatments at hospital discharge and, as a result, performance is improving. However, our knowledge about the long-term use of these interventions is much more limited because of substantial challenges in the collection of outpatient data. To address this issue, Duke investigators have made use of the Duke Databank for Cardiovascular Disease, which has been augmented with follow-up information that includes self-reported medications. The study includes 31 750 patients with coronary artery disease confirmed by catheterization who were seen at Duke from 1995 through 2002. The findings reveal some remarkable insights about the consistent use rates of important secondary prevention therapies. See p 203.MYOCARDIAL VIABILITY TESTING AND THE EFFECT OF EARLY INTERVENTION IN PATIENTS WITH ADVANCED LEFT VENTRICULAR SYSTOLIC DYSFUNCTION, by Tarakji et al.Controversy remains regarding the role of revascularization in patients with heart failure and left ventricular dysfunction. Observational studies suggest that such patients with preserved viability and ischemia benefit from revascularization, but definitive recommendations are constrained by limitations and biases inherent in cohort analyses. In this issue of Circulation, Tarakji and colleagues report on patients referred for positron-emission tomography imaging of viability during consideration of revascularization. Propensity scoring was used to match patients who underwent revascularization to a group that was treated medically. Revascularization was associated with a 48% reduction in the risk of mortality over 3 years. Of interest, the modeled outcomes suggested only minor influence of the extent of viability on the effect of revascularization. Short of a full randomized trial, these data provide the most robust analysis to date of the potential role of revascularization in patients with left ventricular dysfunction. In an accompanying editorial, Gibbons and colleagues (p 180) place these results in context of previous observational studies and ongoing randomized trials, and examine the strengths and weaknesses of such an analytic approach. See p 230.RANDOMIZED TRIAL OF A NONPOLYMER-BASED RAPAMYCIN-ELUTING STENT VERSUS A POLYMER-BASED PACLITAXEL-ELUTING STENT FOR THE REDUCTION OF LATE LUMEN LOSS, by Mehilli et al.Although drug-eluting stents (DES) reduce restenosis and the need for repeat revascularization procedures, concerns over the long-term safety of these devices persist. DES utilize polymers to deliver antirestenotic drugs. The possibility that polymers may promote inflammatory and thrombotic processes and adversely affect vessel wall healing has led to the development of polymer-free stents with a microporous surface as an alternative for local drug delivery. The ISAR-TEST (Intracoronary Stenting and Angiographic Restenosis- Test Equivalence Between 2 Drug-Eluting Stents Trial) investigators studied whether polymer-free stents coated in the cardiac catheterization laboratory with 2% rapamycin solution are not inferior to polymer-based paclitaxel-eluting stents for the prevention of restenosis. They showed no significant differences in in-stent late lumen loss, angiographic restenosis, or target lesion revascularization rates between the nonpolymer rapamycin-stent and polymer paclitaxel-stent groups. Additional studies are necessary to determine the impact of this non-polymer stent system on long term safety end points. See p 273.Visit http://www.circ.ahajournals.org:Clinician UpdateVenous Thromboembolism in Children. See p e12.Images in Cardiovascular MedicineCardiac Teratoma in a Newborn With Right Ventricular Outflow Tract Obstruction. See p e17. Download figureDownload PowerPointNoninvasive Characterization of Left Atrial Mass. See p e19.Architecture of Intracoronary Thrombi in ST-Elevation Acute Myocardial Infarction: Time Makes the Difference. See p e21.Book ReviewSee p e24.CorrespondenceSee p e25. Previous Back to top Next FiguresReferencesRelatedDetails January 17, 2006Vol 113, Issue 2 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.113.2.177 Originally publishedJanuary 17, 2006 PDF download Advertisement