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41. Randomized Controlled Trial for Vestibular Treatment in Concussion

memory. These modules are used to form four composite cores: verbal and visual memories (%), visual motor processing speed (#), and reaction time (sec). The ImPACT takes 20-30 minutes to administer. The interest in ImPACT scores is in both each timepoint to assess cognitive performance against the normal for age and change between time points as an assessment of recovery. Pittsburgh Sleep Quality Index (PSQI) [ Time Frame: enrollment, 2-week, 4-week study visits ] The PSQI will be used to assess (...) : University of Pittsburgh Collaborator: United States Department of Defense Information provided by (Responsible Party): Anthony P. Kontos, Ph.D., University of Pittsburgh Study Details Study Description Go to Brief Summary: A prospective, single-blind, four-group multi-center randomized controlled trial (RCT) of targeted rehabilitation exercises for vestibular symptoms and impairments (T-REV) in civilians with mild traumatic brain injury (mTBI) will be conducted at the University of Pittsburgh Medical

2018 Clinical Trials

42. Cervico-vestibular Rehabilitation for Mild Traumatic Brain Injury

] The severity and impact of symptoms will be measured by a self-reported scale, the PCSS. This scale is a list of 22 symptoms for which participant rate each symptom for severity on a 0 (none) to 6 (severe) numerical scale. The maximum possible score is 132 (22 x 6 = 132). This valid and reliable scale has a minimal detectable change (90% confidence interval) of 12.3 PCSS points. Normative values have been established. The symptoms list can be divided in four main sub-groups (physical, cognitive, emotional (...) Criteria: Patients with more than 30 minutes of loss of consciousness for the current episode; Patients with more than 24 hours of post-traumatic amnesia; Glasgow Coma Scale score lower than 14 at the time of injury; Patients with radiographic evidence of subdural hemorrhage, epidural hemorrhage, intraparenchymal hemorrhage, and cerebral or cerebellar contusion; Post-injury hospitalization for more than 48 hours; Fracture (head, neck and spine); Having a neurological condition, other than the actual

2018 Clinical Trials

43. Patient Modesty: Volume 90

" in ways totally different than the "patient satisfaction" scoring by Ganey. Very interesting and fits with what has been written on this Patient Modesty thread. ..Maurice. At , Anonymous said... Hello, Please read the article (url below) about the lack of informed consent - another blow to patient dignity/ self-determination. http://blogs.einstein.yu.edu/minnesota-case-demonstrates-continuing-erosion-of-informed-consent/?utm_source=The+Doctor%27s+Tablet&utm_campaign=0a4cc73c66-RSS+Subscribers (...) by a dietitian. Because a lot of patients are diabetic, so it’s important. Billy bob is brought by ambulance to the hospital and admitted and he is found to have a high blood sugar of over 600. Technically, he should be in a coma. Billy bob dosen’t like the hospital food cause it tastes bland so Billy Bob orders a pizza from the local Pizza Hut and has it delivered to his room, his favorite, anchovies, pepporini, double cheese and mushrooms. But Billy Bob is non-compliant with the physicians orders regarding

2018 Bioethics Discussion Blog

44. Patient Dignity (Formerly: Patient Modesty): Volume 92

, tacit agreement – no females were allowed. This would be strictly for men and men felt safe in these situations. I don’t think naked military induction exams really became standard until WW1. That’s not to say it didn’t occur during the Crimean War, the American Civil War or the Franco-Prussian War. We’d have to research that. But before “modern” warfare, governments were more interested in bodies in any condition to man the front lines. Doctor’s examining naked bodies didn’t really begin seriously (...) TO THE EXTENT THAT NONE OF YOU CAN TRULY APPRECIATE. PT At , said... Dr. Bernstein, I looked at Volume 12. There were more women participating back then and that was an excellent discussion about the pelvic exams in exchange for birth control. I hope that isn't still as mandatory as it was then. The discussion was as well a bit more focused on patients simply being modest and/or uncomfortable with opposite gender intimate care without going into staff misbehavior or unprofessional behavior as being

2018 Bioethics Discussion Blog

45. Patient Modesty: Volume 91

nurses always let their male patients lie nude longer than really needs too. It is at this time that I am going to give a bigger picture of the more common privacy violations that occur in hospitals. Definition of flashing: Female nurses open up their male patients gowns to expose the patient’s genitals when other female staff enter the male patients’s room. Location, neuro icu, micu, any intensive care unit whereby male patients are comatose by barb induced comas. This unnecessary exposure in the 70

2018 Bioethics Discussion Blog

46. Unusual Cancers of Childhood Treatment (PDQ®): Health Professional Version

patients.[ , ] However, less than 10% of children and adolescents with nasopharyngeal carcinoma presented with distant metastases at diagnosis.[ - ] Prognosis The overall survival of children and adolescents with nasopharyngeal carcinoma has improved over the last four decades; with state-of-the-art multimodal treatment, 5-year survival rates exceed 80%.[ , , , - ] After controlling for stage, children with nasopharyngeal carcinoma have significantly better outcomes than do adults.[ , ] However (...) and analyzed by genome-wide DNA methylation profiling, copy number analysis, immunohistochemistry, and next-generation panel sequencing. Unsupervised hierarchal clustering analysis of DNA methylation data identified the following four distinct clusters:[ ] The largest cluster, which comprised 64% of the samples, had classical histologic features of olfactory neuroblastoma and 10% had recurrent DNMTA3 and TP53 mutations. A second cluster consisted of seven cases with a hypermethylator phenotype and IDH2

2016 PDQ - NCI's Comprehensive Cancer Database

47. Third Universal Definition of Myocardial Infarction

—as little as 20 min, or less in some animal models. 4 It takes several hours before myocardial necrosis can be identi?ed by macroscopic or microscopic post-mortem exam- ination. Complete necrosis of myocardial cells at risk requires at least 2–4 h, or longer, depending on the presence of collateral cir- culation to the ischaemic zone, persistent or intermittent coronary arterial occlusion, the sensitivity of the myocytes to ischaemia, pre- conditioning, and individual demand for oxygen and nutrients. 2

2012 European Society of Cardiology

48. Patient Modesty: Volume 80

published, the topic has been roughly the same and unchanged, essentially, a patient's right for privacy when undressed either in the operating room, procedure room, office exam room or the patient's hospital room. The thread is about the ethical and perhaps legal right for the patient to be able to request and hopefully receive the medical attention by professionals of the patient's desired gender when undergoing a medical examination or procedure. That request to whatever part of the medical system (...) patients has never meant that I was unaware of the concept of modesty especially when applied to genital/rectal areas of the body and breasts in the female. And certainly that is why I always had a female chaperone present with female pelvic exams. But, in my mind, since I got no warnings from my patients, was that they looked at the examination value for their diagnosis and health as trumping any personal modesty issue and accepted that as such. Looking back I am not sure that for some of the requests

2017 Bioethics Discussion Blog

49. Transcranial Electrical Stimulation for mTBI

and post-treatment assessments. Specific Aim 3 will study the relationship among IASIS treatment-related changes in rs-MEG slow-wave imaging, PCS, and neuropsychological measures in Veterans with mTBI. The investigators hypothesize that Reduced MEG slow-wave generation will correlate with reduced total PCS score, individual PCS scores (e.g., sleep disturbance, post-traumatic headache, photophobia, and memory problem symptoms), and improved neuropsychological exam scores between post-IASIS and baseline (...) exams. The success of the proposed research will for the first time confirm that facilitation of slow-wave generation in wakefulness leads to significant therapeutic benefits in mTBI, including an ultimate reduction of abnormal slow-waves accompanied by an improvement in PCS and cognitive functioning. Condition or disease Intervention/treatment Phase Mild Traumatic Brain Injury (mTBI) Post-traumatic Stress Disorder Device: IASIS Micro Current Neurofeedback Not Applicable Study Design Go to Layout

2017 Clinical Trials

50. Inhaled Nitric Oxide After Out-of-Hospital Cardiac Arrest

) [ Time Frame: 90 days after cardiac arrest (+/- 3 days) ] Barthel Index of Independence in Activities of Daily Living scored as a continuous 0-100 at designated time Time to awakening [ Time Frame: Within 4 days of cardiac arrest ] Time in hours until subject is noted to follow commands. Subjects exceeding 96 hours of coma and those that die without awakening will be designated as 100. Methemoglobin level [ Time Frame: Prior to study drug ] Methemoglobin content as proportion (%) of total hemoglobin (...) Inclusion Criteria: Intubated and comatose adult (>18 yo) resuscitated from out-of-hospital cardiac arrest (OHCA)* *Cardiac arrest within an emergency department or outpatient medical center will be included). OHCA includes Emergency Medical Service (EMS) witnessed cardiac arrest. Return of spontaneous circulation (ROSC) within 40 min of CPR initiation Full Outline of Unresponsiveness (FOUR) Brainstem score ≥ 2 (i.e. patient must have pupil OR corneal reflex at the time of ED presentation or within 1h

2017 Clinical Trials

52. CPG for the Management of Invasive Meningococcal Disease

? ltration 95 8.2.4. Extracorporeal membrane oxygenation (ECMO) 95 8.3. Adjuvant therapies 97 8.3.1. Coagulation 97 8.3.2. Immunomodulators 99 8.4. Surgical Management of IMD 101 9. Prognostic and severity factors of IMD 105 9.1. Clinical factors as severity indicators 105 9.2. Severity and mortality risk scoring systems 109 10. Prevention and Control of IMD 113 10.1. Indications for antibiotic prophylaxis 113 10.2. Antibiotics of choice for the prophylaxis of IMD 117 10.3. Meningococcal vaccination (...) or extent of the eruption, eruption progression, presence of fever, stiff neck, irritability or nervousness, lethargy, fatigue, drowsiness, level of consciousness. – Laboratory study: white blood cell count, coagulopathy, CRP, platelets, blood gases, kidney function, liver function, cortisol, glucose, other (CPK, rhabdomyolysis). SEVERITY AND MORTALITY RISK SCORING SYSTEMS 27. In patients with suspected IMD, is there any evidence that the use of any of the following prognostic scales can predict

2013 GuiaSalud

54. Patient Dignity (Formerly: Patient Modesty): Volume 94

of the patient on the belt (entry into the doctor's office, for example) through to the 10 minute history taking and onward to the exam room with its structural and other attending issues of privacy and then perhaps a procedure with the attending assistants and so forth. The "conveyor belt", as in the NEJM article is there starting up actually even before the patient arrived at the major hospital to "prepare" for the "endpoint". The "belt" is for efficiency and meeting some goals set by the profession (...) to financial aspects of medical care but the other misbehaviors toward their patients. What do you think? ..Maurice. At , Anonymous said... Not much preservation of patient dignity at this facility: https://www.theguardian.com/us-news/2019/jan/08/phoenix-woman-coma-gives-birth-hacienda-healthcare-ceo-resigns REL At , said... This Comment was attempted to be posted today on Volume 86 of course closed to further comments but I thought it was worthy of publishing it here on Volume 94. ..Maurice. At Wednesday

2019 Bioethics Discussion Blog

55. Patient Dignity (Formerly:Patient Modesty): Volume 96

healthcare has become the priority while men’s healthcare has not been given much attention. I’d like to explore another reason why some men are dying at a younger age. The reason more men would rather let nature take its course than seek out medical care is due to the lack of Choice, Privacy, and Respect (CPR), afforded men by our medical system. This is especially true when gender specific intimate exams, tests, or procedures come into play. Same gender caregivers are a subject whose time has come (...) givers for an intimate exam, test, and/or procedure will raise his anxiety level through the roof. The medical community’s answer to that is to just say “too bad, it is what it is”. End part 2 NTT At , said... Good Afternoon: Part 3 So, what can be done to alleviate the unnecessary confrontations between male patients and female healthcare workers when male specific intimate issues are in play? First and foremost, the industry has to let go of the dark ages stereotype they’ve branded on all men

2019 Bioethics Discussion Blog

58. Oral anticoagulation with warfarin - 4th edition

be recommended for life‐threatening bleeding. All hospitals and units responsible for anticoagulant care and hospitals performing invasive procedures on patients on warfarin should stock a licensed four‐factor PCC. Recommendation • All hospitals managing patients on warfarin should stock a licensed four‐factor prothrombin complex concentrate ( 1C ). • Emergency anticoagulation reversal in patients with major bleeding should be with 25–50 u/kg four‐factor prothrombin complex concentrate and 5 mg intravenous (...) presentations to Accident and Emergency departments and although national guidelines on the management of head injury exist ( ), these only very briefly deal with the particular problem of patients on warfarin ( ). All patients on warfarin presenting to accident and emergency departments with head injuries, however minor, should have their INR measured. Individuals with loss of consciousness, amnesia or reduced Glasgow Coma scale should have an immediate head computerized tomography (CT) scan. Patients

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2011 British Committee for Standards in Haematology

59. End-of-Life Care During the Last Days and Hours

of life. Some of these prognostic tools (Appendix D) include: ¦ The Palliative Performance Scale (version 2) (Anderson, Downing, Hill, Casorso, & Lurch, 1996) ¦ The Palliative Prognostic Index (Chow et al., 2008; Morito, Tsunoda, Inoue, & Chinara, 1999; Stone, Tierman, & Dooley, 2008). ¦ The Palliative Prognostic Score (Maltoni et al., 1999) In addition to prognostic tools, clinical indicators are another method of identifying individuals who are approaching the last days and hours of life. Specific

2011 Registered Nurses' Association of Ontario

60. CPG on sleep disorders in childhood and adolescence in primary care

and symptoms (Table 22). D Chervin’s Pediatric Sleep Questionnaire (reduced PSQ) is recommended for helping to establish the diagnosis of suspected obstructive sleep apnea-hypopnea syndrome (OSAHS) (Appendix 6). D In addition, a home video-recording could be requested, which can be assessed using Sivan’s videotape recording score to help with the diagnostic suspicion (Appendix 6). D In the event of the con? rmed clinical suspicion of OSAHS, it is advisable to refer the patient to secondary care or Hospital

2011 GuiaSalud

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