Women of the thirteenth moon. The menopause experience. Part I.
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Patients requiring haemodialysis experience various problems, some of which are caused by the medical treatment. We explored various aspects of a haemodialysis patients life, to focus on the effects that their treatment had on their daily life. The aim of this study was "to know the life of the respondent, in order to improve the quality of the assistance." This pilot study allowed the staff to plan arrangements in order that the patient could pursue a "normal life".
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We encountered a case of crescent-type tracheobronchomalacia in a 54-year-old male smoker. The patient experienced extreme obstructive pulmonary changes but his FVC and DLco findings were within the normal ranges. Plain chest X-ray films indicated tracheal narrowing, a diagnosis that was confirmed by fiberoptic bronchoscopy. Two Z-stents were implanted in the trachea but the patient's symptoms did not subside. Thoracic computed tomography (CT) elucidated stenosis of both main bronchi at end-expiration. The implantation of Z-stents in the main bronchi remarkably alleviated the symptoms and improved peak expiratory flow. Six months after implantation, the tracheal stents broke. A favorable course was obtained by inserting an ultraflex stent inside the broken Z-stents. DLco is important to the diagnosis of tracheobronchomalacia, whereas peak expiratory flow and thoracic CT findings are useful in evaluating the effectiveness of treatment. We concluded that ultraflex stents should be the first choice for treatment of tracheal stenosis, and that Z-stents are appropriate for the treatment of bronchial obstruction.
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Work with people who are dying is painful and no palliative caregiver is exempt from this. The emotional pain associated with being a palliative care music therapist is related to professional training, the experience of being a professional minority and new-corner in the workplace, and the intensity and intimacy of the musical workspace. Questions are posed to facilitate music therapist self-reflection. Therapist self-acceptance includes tolerance for imperfection, which, in turn, affects the music's capacity for containment.
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