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At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

[Maternal experiences at the intensive care unit: a phenomenological experience].

This is a phenomenological research in Martin Heidegger's perspective with eight mothers staying with their babies in the hospital, with the aim of understanding their maternal feelings at the ICU of the Albert Sabin Infant Hospital in Fortaleza-CE. The information was obtained by means of phenomenological interviews with the following probing question, "What is it like for you as a mother to be in an ICU and at the same time follow all that goes on in the hospital unit?" and submitted to the analysis of the phenomena sited as proposed by Martins and Bicudo. The experiences of the mothers revealed safety and feer, hope and anguish, potentialities and impotence, existential concerns and expectations of a human being in the world. Beyond these aspects, the mothers showed themselves to be authentic people that got free of the occupation and deal with the pre-occupation.

Humans↗
PubMed2005

Percutaneous transcatheter closure of atrial septal defects: initial single-centre experience and follow-up results. Initial experience with three-dimensional echocardiography.

OBJECTIVE: Registry to report our single-centre experience in closing defects of the atrial septum. METHODS: Between 1996 and 2001, transcatheter device closure of significant atrial septal defects was performed in 32 adults (mean age 45.1 years, range from 15 to 76 years), using different device types. Six patients had a patent foramen ovale (PFO) and 26 patients had a secundum atrial septal defect (ASD II). Defects were selected by means of two-dimensional transoesophageal echocardiography (2D TOE). For 12 defects additional three-dimensional transoesophageal echocardiography (3D TOE) was performed. RESULTS: Mean balloon-stretched diameter was 19.3 mm (range from 11 to 24 mm). A device was successfully placed in all PFO patients (100%) without complications at follow-up. Successful immediate device placement occurred in 24 out of 26 ASD patients. Two immediate placement failures, 1 device embolisation and 1 device non-fixation, occurred and required urgent surgery. There was 1 patient with pericardial effusion after the intervention, requiring pericardiocentesis. Three late placement failures occurred: 2 device embolisations and 1 device dislocation. Clinical success after 3 to 6 months follow-up, defined as the absence of shunt or small shunt, was achieved in all 6 PFO patients and in 21 out of 23 ASD patients (1 device embolisation, requiring surgery, occurred before follow-up was completed). Two patients with significant shunt, 1 late device dislocation and 1 late device embolisation, underwent elective surgery. For patient selection, 3D TOE proved useful in the evaluation of large and/or complex defects. CONCLUSION: Transcatheter device closure of carefully selected atrial septal defects is an alternative to surgery. Although the results are promising, surgical back-up is often needed.

Adolescent↗
PubMed2005

[The experience of life experiences among patients with chronic low back and extremity pain].

PURPOSE: The purpose of this study was to understand the meaning and nature of pain experienced among patients with chronic pain. The present study adopted a hermeneutic phenomenological method which was developed by van Manen. METHOD: The participants for this study were 4 men and 5 women, who were over the age of 20 with chronic pain more than 6 months. Data was collected by using in-depth interviews and observations from September, 2004 to December, 2004. The contents of the interviews were tape-recorded with the consent of the subject. RESULT: The essential themes that fit into the context of the 4 existential grounds of body, time, space and other people were 'untamed and unremitting pain', 'the body as an obstacle', 'continuity of suffering time as if the moment would never end', 'a narrow radial range of action' and 'separating from other people'. CONCLUSION: Patients with chronic pain experienced and perceived the world through the filter of their pain. It is necessary for nurses to understand the experiences of chronic pain patients and to provide more empathic, supportive care. Further research is needed on nursing interventions that could help chronic patients cope with and find the meaning in their suffering.

Adaptation, Psychological↗
PubMedDate not supplied

[Territorial experiment: inter-relational evolution of a group of inmates in the course of an extra-institutional working experiment].

The Authors analize the interrelational evolution of a group of inmates during an outside working activity, with relation to the resocializing experiences which consider the insertion in the area of individuals subjected to detentive security measures. Such evolution, in relation with the influences of the social enviornment one was associated with, was associated with, was marked by an initial cohesion stage between members (of defensive significance), followed by a gradual research of a personal autonomy, in parallel with the acquisition of a reassuring and stabilized role. The utilization of a social space according to the conventional parameters used in the area (with particular concern towards syndical dynamics and rules), reached at the cost of self-exposure, has confirmed the reached maturity and the self balance in proposing themselves to the others as subjects active in their own resocialization, sharing the acquired social rights. Beside the situation concerning the side of the group in its insertion progress, the Authors take into examination the side of the free community in tis receptivity and availability towards the group members, analizing the interactions with the environment as therapeutical moment.

Humans↗
PubMed1999

The belgian experience in unrelated donor bone marrow transplantation: identification of center experience as an important prognostic factor.

BACKGROUND AND OBJECTIVE: We reviewed all unrelated donor bone marrow transplants (UDBMT) performed in Belgium up to December 1995 to identify prognostic factors for relapse, transplant-related mortality and survival. DESIGN AND METHODS: A total of 163 UDBMT were performed in 92 males and 71 females aged 1-55 (median 26) years. Patients were transplanted for ALL (n=35), AML (n=34), CML (n=51), other myeloid malignancies (n=14), SAA (n=21) or miscellaneous other diseases (n=8). Most patients had advanced disease; a few patients were in CR1 (n=10) or early chronic phase (CP) of CML (n=5). RESULTS: Overall survival at 5 yrs was 17% (95% confidence interval: 8-32%), but survival was significantly better for patients with non-malignant disorders (55% at 4 yrs). The relapse rate +/-SE was projected to be 40 (28-54)% at 5 yrs, 36 (20-56)% for standard-risk and 68 (43-85)% for high-risk malignancies (p=0.0029). There was no relapse in CML patients transplanted in 1st CP compared to 68% at 4 yrs with more advanced CML (p=0.0033). Grade II-IV acute graft-versus-host disease (aGVHD) occurred in 55% by day 100 and was strongly modulated by age, ranging from 41% in <20-yr-old to 80% in >40-yr-old patients (p=0. 0021). Transplant-related mortality (TRM) was projected to be 72 (52-87)% at 5 yrs including 2 very late deaths from lung fibrosis and secondary cancer. Main causes of death were original disease in 27, secondary malignancy in 2, GVHD in 28, interstitial pneumonia in 21, other infections in 19, and miscellaneous toxic causes in 21 patients. In multivariate analysis, the relapse rate was strongly dependent on the disease status (p=0.0029), TRM being significantly worse with older age (p=0.0049), and overall survival being significantly worse in more advanced disease (p=0.0006), after a second transplant (p=0.0166), in centers of smaller size (p=0.0316) and in older patients (NS). INTERPRETATION AND CONCLUSIONS: Although results have improved somewhat in recent years, UDBMT remains a procedure with a high TRM. UDBMT should be performed in patients with less advanced diseases and in centers with more experience, particularly in the treatment of adult patients.

Adolescent↗
PubMed2000

[Medical-surgical experience of intestinal intussusception. Experience of a university institution].

BACKGROUND: Management of intestinal intussusception in children has evolved from exclusively surgical treatments to nonoperative reduction under fluoroscopic monitoring. AIM: To report a 10 year experience in a University Hospital in the management of intestinal intussusception. PATIENTS AND METHODS: Seventy two patients, aged 2 to 72 months of age, with an uncomplicated intussusception, that were treated by barium or air enema, were studied. RESULTS: The success rate was 73% with barium reductions, and 100% with air reductions. In 17 patients (24%), enema reduction was unsuccessful and were subjected to a surgical reduction. CONCLUSIONS: Nonsurgical reduction is safe and effective as the initial treatment of uncomplicated intussusception in children.

Air↗
PubMed2001

[Liver transplantation--from experiment to routine care. Experiences from the first 500 liver transplantations in Gothenburg].

During a fifteen-year period, 500 liver transplantations have been performed at Sahlgrenska University Hospital in Göteborg. The results have improved, and factors influencing outcome are discussed. A one-year survival rate over 90% and a 5-year survival rate close to 80% can now be expected for most indications. Long-term complications as well as special problems occurring in different groups of recipients are discussed. New indications for liver transplantation such as liver metastasis of endocrine tumors are described. This article also describes our experience of in situ splitting and living-related liver transplantation as well as other innovations such as cavoportal hemitransposition and multivisceral transplantation.

Adult↗
PubMed2005

[Clinical experience of laparoscopic adrenalectomy: the National Defense Medical College experience].

Twenty-seven laparoscopic adrenalectomies (LapAdx) were performed at the National Defense Medical College between 1999 and 2004. We evaluated the results of LapAdx (group L) compared to the results of open adrenalectomy (group O). Twenty-six of the 27 LapAdx were successfully performed, but one patient with a large pheochromocytoma required open surgey because of arterial bleeding in the renal hilus. The mean operating time in group L (185 +/- 19 min) was not significantly different from that in group O (206 +/- 13 min). The mean estimated blood loss in group L (111 +/- 61 g) was significantly lower than that in group O (308 +/- 67 g). The starting time for oral feeding and for ambulation was significantly earlier in group L than in group O. There was a major complication (intraoperative bleeding) in which a group L patient required a blood transfusion. We also compared the surgical results of 26 patients in LapAdx divided chronologically into the first half and the last half to determine the surgical skill acquired. The operating time was significantly shorter and blood loss significantly less for patients in the last half. In addition, the operating time and blood loss for the first-time LapAdx operators were comparable with those of experienced surgeons. Our results support the efficacy and the minimal invasiveness of LapAdx. The accumulated experience and knowledge regarding laparoscopic surgery in our institute were important in improving surgical procedures and results.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Preservation and relocation of the ovaries in an experiment on female dogs and the initial experience in radical hysterectomy in women].

During an experiment in bitches, the ovaries were placed sub-peritoneally beneath the skin of the abdominal wall preserving the infundibulo-pelvic ligament. A year later a relaparotomy was performed. No alterations were evidenced in the ovaries placed either sub-peritoneally of beneath the skin. In 7 patients of less than 36 years of age, during radical hysterectomy performed for cervical carcinoma the ovaries were placed intraperitoneally at the level of the lower kidney pole, preserving the vascularisation of the infundibulo-pelvic ligament. In one patient a cystic degeneration occurred on the right side, while the ultrasound control did not reveal any pathology in the rest of the patients. A year later the total urine estrogen levels were within normal ranges.

Adult↗
PubMed1990

[Liver transplantation in children. New experience in a Pediatric Surgery unit. Evaluation of the first 18 months' experience].

The authors report an eighteen month experience with orthotopic liver transplantation (OLT) in children in the Pediatric Department of Hospital Bicêtre in Paris, from January 1988 until July 1989. Thirty-eight OLTs including 4 retransplant operations, were performed in 34 children, aged from 7 months to 13 years, 20 of them under the age of 3 years. Biliary atresia was the indication for 22 children. Twenty-eight donors were children. A reduced-size liver was used in 17 cases. The technique for OLT was based on the description by TE Starzl. Surgical complications led to reoperation in 15 cases, mostly in relation to hepatic artery thrombosis (HAT), which occurred in 7 cases: small donor liver was considered to be one of the causative factors. In all but one case of HAT a retransplant was considered; to date it is has been performed in 3 of these children. Thirty-one children have survived, with a mean follow-up of 8 months, all are at home, except for one child at the time of this report. Liver function tests are normal for 22, and moderately altered for 5. For the four remaining children, retransplant is planned for 3 cases and one child has just been retransplanted. The authors emphasise the fact that OLT in small children requires a specialised pediatric environment, particularly as regards intensive care and nursing.

Adolescent↗
PubMed1988

[Problems in the daily management of delusional and hallucinogenic experiences in juvenile schizophrenic patients--experiences with long-term inpatient psychotherapy].

A retrospective personal case study of 43 long-term in-patient treatments of adolescents suffering from first onset schizophrenia with a prolonged course is introduced. 5 criteria were selected combining psychopathological aspects and typical problems of everyday therapeutic management--one criterium being the occurrence of hallucinations and delusions. Only less than half the patients (n = 19), however, suffered from delusions to such a degree that repercussions and consequences on the course and kind of treatment were noticeable. This fact pointed to peculiarities of juvenile schizophrenia in comparison with adult schizophrenia, in which paranoid and hallucinatory phenomena are more prominent, consistent and elaborated. 4 types of delusional and hallucinatory experience with certain ensuing therapeutic reactions are distinguished: Type 1: pseudonormality and denial of delusions, type 2: overlapping of reality and delusion and frantic attempts to separate the two realms, type 3: hallucinatory absorption and trance-like states, type 4: dramatic delusional play and "happy" hallucinations in regressive psychoses. Theories about the perception of reality during the cognitive development in childhood and about altered states of consciousness are discussed and related to different therapeutic approaches.

Adolescent↗
PubMed1989

[Protection of the pancreatico-digestive anastomosis following resection of the head of the pancreas by pancreatic duct occlusion with fibrin (-glue). Animal experiment and clinical experiences].

The pancreatico-digestive anastomosis is especially then endangered by dehiscence when, following resections due to carcinomas, a healthy lienal pancreatic rest has to be connected to the intestine. In the last years the pancreatic duct occlusion (PDO) with Prolamin proved to be possible for the elimination of the disturbing exocrine secretion. Apart from a strong exocrine fibrosis, a deterioration of the endocrine function results too. In animal experiments as well as clinically a simple and effective method for the protection of the pancreatico-digestive anastomosis could be developed by PDO with fibrin sealant (FS). Contrary to PDO with Prolamin a lower-grade, interstitial fibrosis under intact exocrine function is caused due to the short, 6 days at the most lasting blockade of the exocrine pancreatic secretion. Because of the high tryptic activity of the pancreatic juice 20,000 IU/ml Aprotinin were added to the fibrin sealant. So far this method was employed successfully in 36 patients within the scope of Whipple's operations due to pancreatic head carcinomas.

Ampulla of Vater↗
PubMed1989

[Experiences with early fibrinolysis in coronary infarct at an acute care hospital. Second report of experiences with 200 patients 1980 to 1985].

Over the past two decades patients with acute myocardial infarction have been treated with intravenous streptokinase therapy at the hospital in Geldern. Based on experiences in the first study from 1970 to 1979, the second study emphasized instruction on early thrombolytic therapy. Informations were given to general practitioners and to patients at risk for acute myocardial infarction. In the study from 1980 to 1985 the percentage of patients with acute myocardial infarction being treated with thrombolytic agents within two hours after the acute event was 69%. Patients with a duration of ischemia of less than two hours had a significantly decreased in-hospital mortality compared to patients who received therapy more than two hours after onset of symptoms. We conclude that intensified information and instruction of physicians and of patients at risk for myocardial infarction enables early thrombolytic therapy and results in reduced in-hospital mortality of acute myocardial infarction.

Adult↗
PubMed1988

[Clinical experiences of renal and ureteral stones by extracorporeal shock-wave lithotripsy (ESWL). IV: 3-year clinical experience of cases treated with ESWL].

We report our 3-year experience with extracorporeal shock wave lithotripsy (ESWL) since we first used it for upper urinary tract stones on September 1st, 1984. A total of 1,225 patients (1,320 cases) underwent 1,647 sessions with ESWL; They consisted of 855 males (70%) and 370 females (30%). Treated stone locations were 593 renal stones, which contained 112 complete staghorn calculi, 504 ureteral stones, 110 renoureteral stones, and 1 bladder stone. ESWL monotherapy was performed on 90% of cases with renal and ureteral stones, and 46% of cases with complete staghorn calculi. In all the cases so far observed for more than 12 weeks after ESWL, 84.9% of the former showed complete discharge of the stones, and 0.7% showed no change. Only 48.9% of the later showed the complete discharge of the stones, 43.3% of which had residual stones, and 7.8% had fragments of the size of small beans. Complications, which were fever and pain, were noticed in 33.6% of the cases with renal and ureteral stones, and 64.3% of the cases with complete staghorn calculi. After ESWL, hematuria was noticed in almost cases, but the average volume of hemorrhage was 28 +/- 33 ml/day. The only contraindication of ESWL was severe obesity, and in the cases in which spontaneous stone discharge can be expected.

Adolescent↗
PubMed1987

[Methods for determining the glomerular filtration rate in experiments with small animals: position report of the Animal Experiment Diagnosis of Kidney Function Study Group of the Society of Nephrology of East Germany].

The methods of the investigation of the glomerular filtration rate (GFR) in the animal experiment on cats and rats used at present are demonstrated as survey and the results of the basic investigations are compared. The values in cats lie between 20 and 30 ml/min/100 g kidney, in rats GFR values are between 0.6 and 1.0 ml/min/100 g body mass and 0.6-0.3 ml/min/1 g kidney. The basic values are essentially influenced by the experimental conditions and determination methods so that only clearance values within the working team concerned are comparable.

Animals↗
PubMed1977

Angiography with metrizamide. Animal experiments and preliminary clinical experiences.

The non-ionic contrast medium metrizamide (Amipaque) was compared in animal experiments with diatrizoate, iothalamate and metrizoate. Vasodilatory effects, acute intravenous toxicity and effects on red blood cells, pulmonary arterial pressure, endothelium and heart were all less after metrizamide than after the ionic media. This motivated clinical trial of metrizamide for angiography, which demonstrated that metrizamide produced less pain than the ionic monomeric media in femoral as well as in other types of angiography.

Animals↗
PubMed1979

[Vein substitution using PTFE prosthesis--results of animal experiments and initial clinical experiences].

The expanded PTFE prosthesis (Gore Tex), which has been used for 4 years as an artery substitute, was examined in the "low-pressure system" in dogs. In 23 dogs an infrarenal segment of the vena cava was resected and substituted by a Gore Tex prosthesis. In nine dogs an arteriovenous shunt between the right iliac artery and the corresponding vein was also performed. Phlebographic examinations were made 8 days after the operation and at monthly intervals thereafter. After a mean period of 233 days the dogs were killed and histopathologic and electron microscopic analyses performed. Patency was found in 89% of transplants with, and 86% of transplants without, the arteriovenous shunt. Aafter these experiments the Gore Tex prosthesis was implanted successfully in patients suffering from postthrombotic syndrome to serve as a substitute for the superior vena cava and iliac vein. It also acted as a substitute for the jugular vein after neck dissection.

Animals↗