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Quality of life and coping of persons with temporary and permanent stomas.

PURPOSE: To evaluate and compare the use of coping strategies and quality of life (QoL) among individuals with temporary and permanent stomas. DESIGN: Descriptive, cross-sectional. METHODS: After consideration of ethical issues, 42 subjects with temporary stomas and 72 subjects with permanent stomas were interviewed. The Coping Strategies Inventory of Folkman and Lazarus, and Ferrans and Powers QoL Index, both validated for the Brazilian culture, were administered. RESULTS: Subjects from both groups used all coping strategies queried in the Coping Strategies Index and QoL index, but significant differences (P<0.05) were found in use of confrontive, escape-avoidance, and positive reappraisal factors, which were more frequently employed by patients with temporary stoma. QoL scores did not differ between the groups. Significant correlations (P<.001) among subjects with temporary stomas were observed between the family QoL subscale and (a) distancing, (b) self-control, (c) accepting responsibility, (d) escape-avoidance, and (e) positive reappraisal coping factors. Significant correlations were also found between the psychological/spiritual QoL subscale and positive reappraisal factor; between the health/functioning QoL subscale and planful problem solving and positive reappraisal for patients with temporary stomas. Among subjects with permanent stomas, only significant correlations existed between the psychological/spiritual QoL subscale and self-control and social support coping factors. CONCLUSION: Individuals with stomas tend to show positive QoL scores. However, different coping strategies were used by persons with temporary versus permanent stomas.

Adaptation, Psychological↗
PubMed2005

Slit-lamp needle revision of failed filtering blebs using high-dose mitomycin C.

PURPOSE: To investigate the efficacy of bleb needle revision with high-dose mitomycin C in reviving failed filtering blebs after 1 year. PATIENTS AND METHODS: We reviewed the charts of 44 patients with one eye that had undergone bleb needle revision with a mixture of 0.1 mL of mitomycin (0.4 mg/mL) mixed with 0.1 mL of non-preserved 1% lidocaine. At least 12 months of follow-up were required. A successful bleb needle revision was defined as one that did not require a subsequent needling, glaucoma surgery, or medication to reach an intraocular pressure (IOP) greater than 4 mm Hg but less than 22 mm Hg. A qualified success was defined as a successful bleb needle revision that required subsequent needling or medication. RESULTS: The bleb needle revision with high-dose mitomycin was a success or qualified success after 12 months in 28 patients or 64% (95% confidence interval, 50% to 78%). The baseline IOP in these patients was 26.7 +/- 8.2 mm Hg (range 15 to 48 mm Hg) using an average of 1.5 +/- 1.5 glaucoma medications. The IOP after 1 year was 13.6 +/- 4.0 (range 6 to 21 mm Hg) with an average of 0.5 +/- 0.8 medications. Of 44 patients, 17 (39%) were successes and 11 (25%) were qualified successes. CONCLUSION: Bleb needle revision with high-dose MMC was effective in reducing the IOP in 64% of eyes with a failed filtering bleb with minimal long-term complications.

Adult↗
PubMed2003

Long-term outcome of ileal conduit diversion.

PURPOSE: Ileal conduit is considered a safe procedure and the gold standard to which newer forms of urinary diversion should be compared, although few long-term results are known. We analyzed a consecutive series of patients who lived a minimum of 5 years after ileal conduit diversion. MATERIALS AND METHODS: A total of 412 patients underwent ileal conduit diversion between 1971 and 1995 at our institution. We analyzed all conduit related complications occurring later than 3 months after surgery in 131 long-term survivors (survival 5 years or greater). RESULTS: Median followup was 98 months (range 60 to 354). Overall 192 conduit related complications developed in 87 of 131 (66%) patients. The most frequent complications were related to kidney function/morphology in 35 patients (27%), stoma in 32 (24%), bowel in 32 (24%), symptomatic urinary tract infection (including pyelonephritis) in 30 (23%), conduit/ureteral anastomosis in 18 (14%) and urolithiasis in 12 (9%). Within the first 5 years complications developed in 45% of patients. This percentage increased to 50%, 54% and 94% in those surviving 10, 15 and longer than 15 years, respectively. In this last group 50% had upper urinary tract changes and 38% had urolithiasis, for which the respective numbers after 5 years were 12% and 17%. CONCLUSIONS: This study demonstrates a high conduit related complication rate in long-term survivors and underlines the need for vigorous long-term followup. Only studies lasting more than 1 decade cover the entire morbidity spectrum.

Adolescent↗
PubMed2004

Iatrogenic artifacts on whole-body F-18 FDG PET imaging.

PURPOSE: Whole-body F-18 FDG PET images frequently show artifacts related to medical and surgical interventions. We present some of the common artifact patterns in this atlas article. MATERIALS AND METHODS: We studied whole-body F-18 FDG PET images of 30 adult patients (17 males and 13 females). Of these, 9 patients had lymphoma, 7 had colon cancer, 6 had lung cancer, 3 had lung nodules, 2 each had breast and bladder cancer, and 1 patient had brain cancer. All patients had a history of some surgical or medical intervention for malignant or some other associated disease. RESULTS: PET images of 8 patients showed artifacts related to implanted prostheses and ports and 9 patients showed artifacts related to percutaneous insertion or opening of catheters, tubes, and stomas. Six patients had artifacts from previous surgery, 3 from previous radiation therapy, 3 from previous chemotherapy, and 1 from changes in glucose metabolism. CONCLUSIONS: Medical and surgical interventions can give rise to artifacts on whole-body F-18 FDG PET images. The possibilities and patterns of these artifacts should be kept in mind while reporting these studies.

Adult↗
PubMed1991

An animal investigation into the effects of tympanostomy on middle ear mucociliary function and cilia.

The effect of tympanostomy on guinea-pig middle ear mucosa with particular reference to mucociliary function and cilia was investigated. 13 guinea-pigs were used; 5 acted as the control group with no surgical intervention whilst the other 8 had perforations made in one tympanic membrane. 6 weeks later an attempt was made to measure mucociliary function in all the ears, but this was unsuccessful. However, it would appear that fashioning a perforation in the tympanic membrane causes no histological changes in this animal model.

Animals↗
PubMed1989

The nursing preparation of stoma patients for self-care.

The changes brought about by stoma surgery require that patients re-learn self-care skills with regard to elimination. This is accomplished as an integral part of postoperative nursing care. In this paper, some of the findings of a study are presented on the nursing preparation of stoma patients for self-management of their appliance. The observations made showed that, even at the end of their postoperative period in hospital, the patients in the study was receiving considerable nursing assistance in the management of their appliance and had not demonstrated new self-care skills for all aspects of the physical care of the stoma. It is concluded that these findings highlight a need to examine the methods of preparation for self-care of stoma patients in hospital, as containment rather than control of elimination remains a key issue in their rehabilitation.

Adaptation, Psychological↗