scholarly journals Vacuum-Assisted Abdominal Closure Is Safe and Effective: A Cohort Study in 74 Consecutive Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
R. O. Jensen ◽  
T. Buchbjerg ◽  
R. M. Simonsen ◽  
R. Eckardt ◽  
N. Qvist
Keyword(s):  
Mental Health ◽  
Intensive Care Unit ◽  
Conventional Treatment ◽  
Primary Closure ◽  
Randomized Study ◽  
Vacuum Assisted Closure ◽  
Prospective Multicenter Study ◽  
Enteroatmospheric Fistula ◽  
Secondary Closure ◽  
Physical Health Score

Background. Vacuum-assisted closure (VAC) has, in many instances, become the treatment of choice in patients with abdominal catastrophes. This study describes the use and outcome of ABThera KCI® VAC in the Region Southern Denmark covering a population of approximately 1.202 mill inhabitants.Method. A prospective multicenter study including all patients treated with VAC during an eleven-month period.Results. A total of 74 consecutive patients were included. Median age was 64.4 (9–89) years, 64% were men, and median body mass index was 25 (17–42). Duration of VAC treatment was median 4.5 (0–39) days with median 1 (0–16) dressing changes. Seventy per cent of the patients attended the intensive care unit. The 90-day mortality was 15%. A secondary closure of the fascia was obtained in 84% of the surviving patients. Only one patient developed an enteroatmospheric fistula. Patients with secondary closure were less likely to develop large hernias and had better self-evaluated physical health score (p< 0,05). No difference in mental health was found.Conclusion. The abdominal VAC treatment in patients with abdominal catastrophes is safe and with a relative low complication rate. Whether it might be superior to conventional treatment with primary closure when possible has yet to be proven in a randomized study.

Parent Psychological Distress in the Neonatal Intensive Care Unit Within the Context of the Social Ecological Model: A Scoping Review

2018 ◽  
Vol 24 (6) ◽  
pp. 495-509 ◽  
Author(s):  
Kristy Loewenstein
Keyword(s):  
Mental Health ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychological Distress ◽  
Neonatal Intensive Care Unit ◽  
Scoping Review ◽  
Neonatal Intensive Care ◽  
Family Cohesion ◽  
Ecological Model ◽  
Well Being

BACKGROUND: Neonatal intensive care unit (NICU) parents are at risk for psychological distress and impaired mental health, and statistics related to parent psychological distress vary. OBJECTIVE: To determine the scope of literature regarding the mental health and psychosocial well-being of parents in the NICU. DESIGN: A scoping review within the Arksey and O’Malley framework and the SEM was undertaken to answer, “What factors contribute to parent’s mental health in the NICU?” A systematic review of the literature was performed using the PRISMA methodology. RESULTS: Common socioeconomic factors and infant and parent characteristics may place parents at a greater risk for developing distress. History of mental illness, family cohesion, birth trauma, altered parenting role, gestational age, birth weight, and severity of prematurity/illness emerged as themes. CONCLUSION: Further research is required to provide a standard for the screening and assessment of parents’ mental health and psychosocial well-being during a NICU hospitalization. The experiences of nonbirth parents in the NICU should be explored to examine the effects of the hospitalization on all types of parents.

scholarly journals Recent Exposure to Caspofungin or Fluconazole Influences the Epidemiology of Candidemia: a Prospective Multicenter Study Involving 2,441 Patients

2010 ◽  
Vol 55 (2) ◽  
pp. 532-538 ◽  
Author(s):  
Olivier Lortholary ◽  
Marie Desnos-Ollivier ◽  
Karine Sitbon ◽  
Arnaud Fontanet ◽  
Stéphane Bretagne ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Odds Ratio ◽  
Susceptibility Testing ◽  
Antifungal Susceptibility ◽  
Bloodstream Infections ◽  
Antifungal Drugs ◽  
Surveillance Program ◽  
Prospective Multicenter Study ◽  
Recent Exposure ◽  
Adults And Children

ABSTRACTA prospective multicenter surveillance program on yeast bloodstream infections was implemented in the Paris, France, area without restrictions on ward of hospitalization (intensive care unit, hematology, and surgery) or age (adults and children). The present analysis concerns 2,618 isolates collected over 7 years from 2,441 patients. Centralized species identification and antifungal susceptibility testing using the EUCAST methodology were performed. Almost 10% (232/2,441) of the patients had recently (≤30 days) been treated with antifungal drugs. We analyzed the effect of recent exposure to fluconazole (n= 159) or caspofungin (n= 61) on the proportions of the five majorCandidaspecies. For both drugs, preexposure was associated with a decreased prevalence ofCandida albicansin favor of less drug-susceptible species (C. glabrataandC. kruseifor the former andC. parapsilosisand, to a lesser extent,C. glabrataandC. kruseifor the latter;P= 0.001). In the multivariate analysis, the risk of being infected with an isolate with decreased susceptibility to fluconazole was independently associated with an age of ≥15 years (odds ratio [OR] = 2.45; 95% confidence interval [CI] = 1.39 to 4.31;P= 0.002) and with recent exposure to fluconazole (OR = 2.17; 95% CI = 1.51 to 3.13;P< 0.001), while the risk of being infected with an isolate with decreased susceptibility to caspofungin was independently associated with an age <15 years (OR = 2.53; 95% CI = 1.43 to 4.48;P= 0.001) and with recent exposure to caspofungin (OR = 4.79; 95% CI = 2.47 to 9.28;P< 0.001). These findings could influence future recommendations for the management of candidemia.

scholarly journals Physician Self-disclosure of Lived Experience Improves Mental Health Attitudes Among Medical Students: A Randomized Study

2020 ◽  
Vol 7 ◽  
pp. 238212051988935 ◽  
Author(s):  
Andrés Martin ◽  
Julie Chilton ◽  
Doron Gothelf ◽  
Doron Amsalem
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Medical Students ◽  
Help Seeking ◽  
Randomized Study ◽  
Role Modeling ◽  
Mental Illnesses ◽  
Control Group ◽  
Health Seeking ◽  
Health Seeking Behaviors

Introduction: Depression and suicidal ideation are common among medical students, a group at higher risk for suicide completion than their age-normed peers. Medical students have health-seeking behaviors that are not commensurate with their mental health needs, a discrepancy likely related to stigma and to limited role-modeling provided by physicians. Methods: We surveyed second-year medical students using the Attitudes to Psychiatry (ATP-30) and Attitudes to Mental Illness (AMI) instruments. In addition, we asked questions about role-modeling and help-seeking attitudes at baseline. We then conducted a randomized trial of an intervention consisting of 2 components: (a) a panel of 2 physicians with personal histories of mental illness speaking about their diagnosis, treatment, and recovery to the students, immediately followed by (b) small-group facilitated discussions. We repeated the ATP-30 and AMI after the active/early group was exposed to the panel, but before the control/late group was similarly exposed. Results: Forty-three medical students participated (53% women). The majority of students (91%) agreed that knowing physicians further along in their careers who struggled with mental health issues, got treatment, and were now doing well would make them more likely to access care if they needed it. Students in the active group (n = 22) had more favorable attitudes on ATP-30 ( P = .01) and AMI ( P = .02) scores, as compared with the control group (n = 21). Conclusion: Medical students can benefit from the availability of, and exposure to physicians with self-disclosed histories of having overcome mental illnesses. Such exposures can favorably improve stigmatized views about psychiatry, or of patients or colleagues affected by psychopathology. This intervention has the potential to enhance medical students’ mental health and their health-seeking behaviors.

scholarly journals Perceived stress and post-traumatic stress disorder symptoms among intensive care unit staff caring for severely ill coronavirus disease 2019 patients during the pandemic: a national study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nisha Kader ◽  
Bushra Elhusein ◽  
Nirvana Swamy Kudlur Chandrappa ◽  
Abdulqadir J. Nashwan ◽  
Prem Chandra ◽  
...  
Keyword(s):  
Mental Health ◽  
Intensive Care Unit ◽  
Perceived Stress ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Well Being ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

Abstract Background Intensive care unit (ICU) staff have faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic, which could significantly affect their mental health and well-being. The present study aimed to investigate perceived stress and post-traumatic stress disorder (PTSD) symptoms reported by ICU staff working directly with COVID-19 patients. Methods The Perceived Stress Scale was used to assess perceived stress, the PTSD Diagnostic Scale for the Diagnostic and Statistical Manual of Mental Disorders (5th edition) was used to determine PTSD symptoms, and a sociodemographic questionnaire was used to record different sociodemographic variables. Results Altogether, 124 participants (57.2% of whom were men) were included in the analysis. The majority of participants perceived working in the ICU with COVID-19 patients as moderately to severely stressful. Moreover, 71.4% of doctors and 74.4% of nurses experienced moderate-to-severe perceived stress. The staff with previous ICU experience were less likely to have a probable diagnosis of PTSD than those without previous ICU experience. Conclusions Assessing perceived stress levels and PTSD among ICU staff may enhance our understanding of COVID-19-induced mental health challenges. Specific strategies to enhance ICU staff’s mental well-being during the COVID-19 pandemic should be employed and monitored regularly. Interventions aimed at alleviating sources of anxiety in a high-stress environment may reduce the likelihood of developing PTSD.

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