Alternating antineutrophil cytoplasmic antibody specificity: drug-induced vasculitis in a patient with Wegener's granulomatosis. (1/732)
We describe a patient who presented with Wegener's granulomatosis associated with antineutrophil cytoplasmic antibodies (ANCA) directed against proteinase 3 (PR3) with a cytoplasmic immunofluorescence pattern (cANCA), whose ANCA type changed to antimyeloperoxidase antibodies with a perinuclear immunofluorescence pattern (pANCA) when treated with propylthiouracil, and changed back to anti-PR3 antibodies with cANCA after the medication was discontinued. The patient developed flares of vasculitis symptoms associated with rises in either type of ANCA. Tests for antimyeloperoxidase ANCA were repeatedly negative before the drug was started, strongly implicating the drug as the cause of the episode. This case demonstrates that patients with idiopathic ANCA-positive vasculitis may quickly develop a superimposed drug-associated ANCA-positive vasculitis. Iatrogenic vasculitis should be suspected when a patient with idiopathic vasculitis with one type of ANCA develops the other type of ANCA. (+info)Understanding adverse events: human factors. (2/732)
(1) Human rather than technical failures now represent the greatest threat to complex and potentially hazardous systems. This includes healthcare systems. (2) Managing the human risks will never be 100% effective. Human fallibility can be moderated, but it cannot be eliminated. (3) Different error types have different underlying mechanisms, occur in different parts of the organisation, and require different methods of risk management. The basic distinctions are between: Slips, lapses, trips, and fumbles (execution failures) and mistakes (planning or problem solving failures). Mistakes are divided into rule based mistakes and knowledge based mistakes. Errors (information-handling problems) and violations (motivational problems) Active versus latent failures. Active failures are committed by those in direct contact with the patient, latent failures arise in organisational and managerial spheres and their adverse effects may take a long time to become evident. (4) Safety significant errors occur at all levels of the system, not just at the sharp end. Decisions made in the upper echelons of the organisation create the conditions in the workplace that subsequently promote individual errors and violations. Latent failures are present long before an accident and are hence prime candidates for principled risk management. (5) Measures that involve sanctions and exhortations (that is, moralistic measures directed to those at the sharp end) have only very limited effectiveness, especially so in the case of highly trained professionals. (6) Human factors problems are a product of a chain of causes in which the individual psychological factors (that is, momentary inattention, forgetting, etc) are the last and least manageable links. Attentional "capture" (preoccupation or distraction) is a necessary condition for the commission of slips and lapses. Yet, its occurrence is almost impossible to predict or control effectively. The same is true of the factors associated with forgetting. States of mind contributing to error are thus extremely difficult to manage; they can happen to the best of people at any time. (7) People do not act in isolation. Their behaviour is shaped by circumstances. The same is true for errors and violations. The likelihood of an unsafe act being committed is heavily influenced by the nature of the task and by the local workplace conditions. These, in turn, are the product of "upstream" organisational factors. Great gains in safety can ve achieved through relatively small modifications of equipment and workplaces. (8) Automation and increasing advanced equipment do not cure human factors problems, they merely relocate them. In contrast, training people to work effectively in teams costs little, but has achieved significant enhancements of human performance in aviation. (9) Effective risk management depends critically on a confidential and preferable anonymous incident monitoring system that records the individual, task, situational, and organisational factors associated with incidents and near misses. (10) Effective risk management means the simultaneous and targeted deployment of limited remedial resources at different levels of the system: the individual or team, the task, the situation, and the organisation as a whole. (+info)Parotid neoplasms: a report of 250 cases and review of the literature. (3/732)
A 25-year experience with parotid tumors was reviewed. From a total of 250 neoplasms, 173 were histologically benign and 77 were malignant. Benign mixed tumors accounted for 59% of all lesions. Clinical parameters used to diagnose parotid neoplasms were found to be unreliable in determining whether a given tumor was benign or malignant. The mean age for malignant lesions was 10 years greater than for benign lesions. The phenomenon of malignant transformation of a benign tumor was considered in four patients. Complete surgical excision is the safest and preferred method for diagnosis. Preoperative needle or incisional biopsy are associated with a high degree of local recurrence. The appropriate management of any parotid tumor is predicated on special histological type. Local excision or enucleation no longer have a place in the surgical management of benign parotid tumors. Postoperative tumor recurrence and morbidity are directly related to awareness of surgical anatomy and pursuit of correct surgical techniques for adequate resection. The five-year recurrence rate for 102 benign mixed tumors was 6%. Recurrence in malignant tumors varied with specific histological types but was generally high. Five-year survival for all malignant parotid tumors was 48%. (+info)Patients' experience of surgical accidents. (4/732)
OBJECTIVE: To examine the psychological impact of surgical accidents and assess the adequacy of explanations given to the patients involved. DESIGN: Postal questionnaire survey. SETTING: Subjects were selected from files held Action for Victims of Medical Accidents. PATIENTS: 154 surgical patients who had been injured by their treatment, who considered that their treatment had fallen below acceptable standards. MAIN MEASURES: Adequacy of explanations given to patients and responses to standard questionnaires assessing pain, distress, psychiatric morbidity, and psychosocial adjustment (general health questionnaire, impact of events scale, McGill pain questionnaire, and psychosocial adjustment to illness scale). RESULTS: 101 patients completed the questionnaires (69 women, 32 men; mean age 44 (median 41.5) years. Mean scores on the questionnaires indicated that these injured patients were more distressed than people who had suffered serious accidents or bereavements; their levels of pain were comparable, over a year after surgery, to untreated postoperative pain; and their psychosocial adjustment was considerably worse than in patients with serious illnesses. They were extremely unsatisfied with the explanations given about their accident, which they perceived as lacking in information, unclear, inaccurate, and given unsympathetically. Poor explanations were associated with higher levels of disturbing memories and poorer adjustment. CONCLUSIONS: Surgical accidents have a major adverse psychological impact on patients, and poor communication after the accident may increase patients' distress. IMPLICATIONS: Communication skills in dealing with such patients should be improved to ensure the clear and comprehensive explanations that they need. Many patients will also require psychological treatment to help their recovery. (+info)Image-guided central venous catheters for apheresis. (5/732)
Apheresis is an increasingly important procedure in the treatment of a variety of conditions, sometimes performed via peripheral access because of concern over major complications associated with central venous catheter (CVC) placement. This study sought to determine the safety and success for ultrasound and fluoroscopically guided, non-tunneled dual lumen CVCs placed for apheresis. Prospective data collection was made of 200 attempted CVC placements in the radiology department utilizing real time sonographic guidance. The complications relating to placement were noted in all and the number of passes required for venepuncture and whether a single wall puncture was achieved was recorded in 185 cases. Duration of catheterization and reason for line removal were recorded in all. Our study group included 71 donors providing peripheral blood stem cells for allogeneic transplant. CVCs were successfully placed in all patients, 191 lines in the internal jugular and seven in the femoral vein. 86.5% required only a single pass and 80.5% with only anterior wall puncture. Inadvertent but clinically insignificant arterial puncture occurred in six (3%) cases. In no case did this prevent line placement. There were no other procedure-related complications. 173 (87.4%) catheters were removed the same day. No catheters were removed prematurely. There was one case of prolonged venous bleeding. Our study demonstrates the safety of central venous catheters for apheresis provided that duration of catheterization is short and real-time sonographic guidance is used for the puncture, and guide wire and catheter placement are confirmed fluoroscopically. (+info)Empirically supported treatments in pediatric psychology: procedure-related pain. (6/732)
OBJECTIVE: To use the Chambless criteria for empirically supported treatments and determine if any interventions for procedure-related pain in children and adolescents can be designated as "well established," "probably efficacious," or "promising." METHODS: The Chambless criteria were applied to 13 treatment outcome studies identified by a comprehensive literature review. RESULTS: A detailed summary is provided for each study, including the following information: citation, subjects, diagnostic criteria, baseline, experimental design, assessment measures, treatment protocol, outcome, and follow-up. CONCLUSIONS: Cognitive behavioral therapy is a "well-established treatment" for procedure-related pain in children and adolescents. Treatment includes breathing exercises and other forms of relaxation and distraction, imagery and other forms of cognitive coping skills, filmed modeling, reinforcement/incentive, behavioral rehearsal, and active coaching by a psychologist, parent, and/or medical staff member. I discuss future challenges for biobehavioral research and practice in the area of procedure-related pain. (+info)Empirically supported treatments in pediatric psychology: disease-related pain. (7/732)
OBJECTIVE: To evaluate psychological literature addressing interventions for disease-related pain in children. METHODS: We conducted a literature review of all studies using psychological interventions for pain stemming directly from disease process as well as pain secondary to disease treatment. RESULTS: Few empirically validated psychological approaches to the treatment of disease pain were found. Although existing intervention studies do not meet Chambless criteria, some promising strategies were identified. CONCLUSIONS: Clinical evidence suggests that cognitive-behavioral strategies for the management of disease pain in children are promising and manualized, controlled intervention studies are needed. (+info)Closure techniques for fetoscopic access sites in the rabbit at mid-gestation. (8/732)
Operative fetoscopy may be limited by its relatively high associated risk of preterm prelabour rupture of membranes. The objective of this study was to study closure techniques of the access site for fetoscopy in the mid-gestational rabbit. A total of 32 does (288 amniotic sacs) at 22 days gestational age (GA; term = 32 days) underwent 14 gauge needle fetoscopy, by puncture through surgically exposed amnion. Entry site was randomly allocated to four closure technique groups: myometrial suture (n = 14), fibrin sealant (n = 15), autologous maternal blood plug (n = 13), collagen plug (n = 14); 16 sacs were left unclosed (positive controls), and the unmanipulated 216 sacs were negative controls. Membrane integrity, presence of amniotic fluid and fetal lung to body weight ratio (FLBWR) were evaluated at 31 days GA. Following fetoscopy without an attempt to close the membranes, amniotic integrity was restored in 41% of cases (amniotic integrity in controls 94%; P = 0.00001). When the access site was surgically closed, the amnion resealed in 20-44% of cases, but none of the tested techniques was significantly better than the others or than positive controls. Permanent amniotic disruption was associated with a significantly lower FLBWR in all groups. In conclusion, the rate of fetoscopy-induced permanent membrane defects in this model did not improve by using any of the closure techniques tested here. (+info)'Iatrogenic disease' is a term used to describe conditions or disorders that are inadvertently caused by medical treatment or intervention, whether it be through the actions of healthcare professionals or the use of medications and other therapies.
Iatrogenic disease refers to any condition or illness that is caused, directly or indirectly, by medical treatment or intervention. This can include adverse reactions to medications, infections acquired during hospitalization, complications from surgical procedures, or injuries caused by medical equipment. It's important to note that iatrogenic diseases are unintended and often preventable with proper care and precautions.
Iatrogenic Creutzfeldt-Jakob Disease, Final Assessment - Volume 18, Number 6-June 2012 - Emerging Infectious Diseases journal -...
Iatrogenic Creutzfeldt-Jakob Disease, Final Assessment. Emerging Infectious Diseases. 2012;18(6):901-907. doi:10.3201/ ... Furtner M, Gelpi E, Kiechl S, Knoflach M, Zangerl A, Gotwald T, Iatrogenic Creutzfeldt-Jakob disease 22 years after human ... Iatrogenic Creutzfeldt-Jakob Disease, Final Assessment On This Page CME Introduction Human Growth Hormone Dura Mater Current ... Iatrogenic Creutzfeldt-Jakob disease: the waning of an era. Neurology. 2006;67:389-93. DOIPubMedGoogle Scholar ...
iatrogenic disease Archives - Cleanse And Purify Thyself
Alzheimer-type neuropathology in a 28 year old patient with iatrogenic Creutzfeldt-Jakob disease after dural grafting | Journal...
Alzheimer-type neuropathology in a 28 year old patient with iatrogenic Creutzfeldt-Jakob disease after dural grafting ... Alzheimer-type neuropathology in a 28 year old patient with iatrogenic Creutzfeldt-Jakob disease after dural grafting ... Alzheimer-type neuropathology in a 28 year old patient with iatrogenic Creutzfeldt-Jakob disease after dural grafting ...
Hypocalcemic generalised seizures as a manifestation of iatrogenic hypoparathyroidism months to years after thyroid surgery
Iatrogenic Disease* * Middle Aged * Postoperative Complications* * Seizures / diagnosis * Seizures / etiology* * Severity of ... Iatrogenic hypoparathyroidism needs to be considered in the differential diagnosis of adult-onset, generalised, tonic-clonic ... Hypocalcemic generalised seizures as a manifestation of iatrogenic hypoparathyroidism months to years after thyroid surgery ...
06. Iatrogenic Disease (Medical Error) | Video
Results of search for 'su:{Iatrogenic disease.}' › WHO HQ Library catalog
Parasitic omental endometrioma: an unexpected iatrogenic sequalae of morcellation in disseminating de novo benign peritoneal...
T2 - an unexpected iatrogenic sequalae of morcellation in disseminating de novo benign peritoneal disease ... an unexpected iatrogenic sequalae of morcellation in disseminating de novo benign peritoneal disease. Journal of Obstetrics and ... an unexpected iatrogenic sequalae of morcellation in disseminating de novo benign peritoneal disease. Journal of Obstetrics and ... an unexpected iatrogenic sequalae of morcellation in disseminating de novo benign peritoneal disease. In: Journal of Obstetrics ...
Iatrogenic anemia - Wikipedia
This iatrogenic anemia often occurs alongside the anemia caused by kidney disease.: 629 Another factor that contributes to ... People who develop iatrogenic anemia spend a longer amount of time in the hospital and have an increased risk of mortality. ... Iatrogenic anemia, also known as nosocomial anemia or hospital-acquired anemia, is a condition in which a person develops ... Iatrogenic anemia is of particular concern in intensive care medicine,: 629 because people who are critically ill require ...
Use of administrative data to find substandard care: validation of the complications screening program
Iatrogenic Cushing Syndrome: Practice Essentials, Frequency, Mortality/Morbidity
While endogenous Cushing syndrome is a rare disease, iatrogenic (drug-related or exogenous) Cushing syndrome from ... encoded search term (Iatrogenic Cushing Syndrome) and Iatrogenic Cushing Syndrome What to Read Next on Medscape ... Iatrogenic Cushing Syndrome. Updated: Sep 30, 2022 * Author: Ha Cam Thuy Nguyen, MD; Chief Editor: Romesh Khardori, MD, PhD, ... Iatrogenic Cushing Syndrome from Interaction Between Ritonavir and Oral Budesonide During Direct Acting Antiviral Hepatitis C ...
Iatrogenic Kaposi sarcoma of the small bowel in Crohn's disease following short-term use of immunomodulators: a case report and...
This is the fifth case of Kaposi sarcoma developed over the small intestine in a patient with Crohns disease following ... Intestinal Kaposi sarcoma in patients with inflammatory bowel disease is extremely rare. A 46-year-old East Asian male with ... Thus, in patients with inflammatory bowel disease, if symptoms are aggravated or do not abate after immunomodulators ... in which case it is known as iatrogenic Kaposi sarcoma or drug-induced Kaposi sarcoma. ...
Clinical Interventions in Aging | Volume 6 - Dove Press Open Access Publisher
Intrinsic diseases of aging Metabolic therapies Indicators of disease risk Health-oriented approach to aging (as opposed to a ... disease-oriented one) Clinical options to combat the maladaptive effects of aging Replacement of essential substances whose ... decline during aging Managing functional decline during senescence Preventing or delaying the onset of intrinsic diseases of ... especially by tempering or preventing the onset of age-related disease.Subject areas include: ...
Safety in Numbers: Evidence-based Development of a Medicine Management Learning Tool. | PSNet
Patient Safety. | PSNet
Creutzfeldt-Jakob disease: MedlinePlus Medical Encyclopedia
Creutzfeldt-Jakob disease (CJD) is a form of brain damage that leads to a rapid decrease in movement and loss of mental ... Creutzfeldt-Jakob disease (CJD) is a form of brain damage that leads to a rapid decrease in movement and loss of mental ... Iatrogenic CJD is also an acquired form of the disease. Iatrogenic CJD is sometimes passed through a blood product transfusion ... Early in the disease, a nervous system and mental exam will show memory and thinking problems. Later in the disease, a motor ...
An Open Letter to Doctors - Vitality Magazine
Coming Out: Iatrogenic Illness Awareness Month - Mad In America
I also suspect that many recognized diseases are iatrogenic - autoimmune diseases, fibromyalgia, chronic fatigue, M.E., etc. I ... Every time one small piece is championed here and there (as opposed to the totality of all iatrogenic death, disease, addiction ... Iatrogenic damage is defined as a state of ill health or adverse effect resulting from medical treatment. As many MIA readers ... All causes of iatrogenic injury should be considered as part and parcel of the problem regardless of what the mechanism of ...
Timing and type of surgical treatment of Clostridium diffici... : Journal of Trauma and Acute Care Surgery
Clostridium difficile colitis: an increasingly aggressive iatrogenic disease? Arch Surg. 2002; 137: 1096-1100.. ... Temporal trends in disease outcomes related to Clostridium difficile infection in patients with inflammatory bowel disease. ... admission and their disease leads to colectomy or death.2 Fulminant C. difficile-associated disease (CDAD) is defined as severe ... Analysis of 30-day mortality for Clostridium difficile-associated disease in the ICU setting. Chest. 2007; 132: 418-424.. *View ...
JUST A MINUTE, SURGEON:TEN QUESTIONS TO ASK BEFORE YOU SUBMIT TO SURGERY, PLUS A SURVIVAL GUIDE FOR YOUR STAY IN HOSPITAL. -...
The hospital is the focus of iatrogenic, or medically induced, disease. It comes from:. Unnecessary surgery. In the US some six ... Diseases (such as AIDS or hepatitis), errors and complications cause about one death in 9,000 operations and more illness.. ... Most diseases can be helped to some extent by dietary, acupuncture, osteopathic/chiropractic, psychotherapeutic, homoeopathic ... Smaller community hospitals are often friendlier, with less chance of giving you a new disease or complication than the big ...
Is Complex PTSD a Valid Diagnosis? | Psychology Today
Iatrogenic diseases are ailments understood to be caused by medical treatment, mistreatment, or misdiagnosis. An infamous ... To this end, I offer the terms para-iatrogenic, or pseudo-iatrogenic to draw the readers attention to a booming alternative ... Decreases in infectious disease and allergen exposure in the West have similarly been shown to correlate with increases in ... In 2020, the WHOs International Classification of Diseases, 11th Edition (ICD11), introduced CPTSD as a new diagnostic ...
Neil Cashman - Google Scholar
Iatrogenic Creutzfeldt-Jakob disease at the millennium. P Brown, M Preece, JP Brandel, T Sato, L McShane, I Zerr, A Fletcher ... in Neurodegenerative Disease, University of Wollongong, Illawarra Health and Medical ResearchVerified email at uow.edu.au ... Kennedys disease: caspase cleavage of the androgen receptor is a crucial event in cytotoxicity. LM Ellerby, AS Hackam, SS ...
Readers Corner: ANH-USA's Connections and Position on World Government - Alliance for Natural Health USA - Protecting Natural...
Herbs, Knives and Plastic: 150 Years of Abortion in South Africa | SpringerLink
The AMEDEO Literature Guide
Alzheimers disease neuropathological change three decades after iatrogenic amyloid-beta transmission.. Acta Neuropathol. 2021 ... Molecular characterisation defines clinically-actionable heterogeneity within Group 4 medulloblastoma and improves disease risk ... Necrotic reshaping of the glioma microenvironment drives disease progression.. Acta Neuropathol. 2022 Jan 17. pii: 10.1007/ ...