Optical coherence tomography analysis of bilateral end-stage choroidal neovascularization where one eye is treated with photodynamic therapy

BACKGROUND: To compare retinal thickness and subretinal hyper-reflectivity using Stratus optical coherence tomography (OCT3) between the eyes of patients with bilateral end-stage exudative age-related macular degeneration (AMD), where one eye has been treated with photodynamic therapy (PDT). METHODS: Patients with PDT-treated stable choroidal neovascularization (CNV), defined as a fibrotic lesion not requiring treatment for 6 months, in one eye and an untreated end-stage CNV (disciform) scar in their fellow eye, underwent refraction protocol logMAR visual acuity (VA) in letters, slit-lamp biomicroscopy, fluorescein angiography and OCT3 scan. Subretinal scar thickness was measured as Outer High Reflectivity Band Thickness (OHRBT) and retinal thickness as neuroretinal foveal thickness (NFT) on OCT3. RESULTS: Thirty-two eyes of 16 patients were studied. Mean OHRBT was 255.62 microm in treated eyes and 350.8 microm in untreated eyes (P = 0.001). Mean NFT was 130.3 microm in the treated eye and 79.9 microm in the untreated eye (P = 0.017). Mean VA was 42 letters in treated eyes and 15 letters in untreated eyes (P < 0.005). CONCLUSION: Based on OCT3 findings, eyes with AMD treated with PDT have a thinner fibrous scar and better preserved retinal thickness when compared with untreated fellow eyes with end-stage fibrotic scarring.     

An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings

In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has reported on statistics regarding restraint, how and why it is used, and staff and service user perspectives about its use. However, there is limited evidence directly exploring the physical and psychological harm restraint may cause to people being cared for within mental health inpatient settings. This study reports on an integrative review of the literature exploring available evidence regarding the physical and psychological impact of restraint. The review included both experimental and nonexperimental research papers, using Cooper's (1998) five‐stage approach to synthesize the findings. Eight themes emerged: Trauma/retraumatization; Distress; Fear; Feeling ignored; Control; Power; Calm; and Dehumanizing conditions. In conclusion, whilst further research is required regarding the physical and psychological implications of physical restraint in mental health settings, mental health nurses are in a prime position to use their skills and knowledge to address the issues identified to eradicate the use of restraint and better meet the needs of those experiencing mental illness.     

A Systematic Review of the Patient- and Carer-Related Factors Affecting the Experience of Pain for Advanced Cancer Patients Cared for at Home

Context

Effective pain management is a priority in the palliative care of advanced cancer patients. A body of research is emerging examining the factors that influence the management and experience of pain for such individuals. Identifying such factors should allow for the development of targeted interventions to improve pain management in the home while ultimately reducing unnecessary suffering for the patient.

Subclonal acquisition of a BCR::ABL1 fusion in a chronic myelomonocytic leukemia

Annals of Hematology -     

Feasibility of an interprofessional collaborative osteoporosis screening programme in Malaysia

Background Population screening for osteoporosis using bone mineral density scan is not feasible in Malaysia as this test is costly. Hence, there is a need to develop a more efficient method to screen for osteoporosis.Objectives To determine the feasibility of an interprofessional collaborative osteoporosis screening programme (IPC-OSP). Methods Postmenopausal women aged?≥?50 years, who had not been diagnosed with osteoporosis were recruited from a primary care clinic from June to August 2014. Patients were assessed for their osteoporosis risk and were counselled on prevention methods. Patients at risk were referred to the doctor with a recommendation for a bone mineral density (BMD) scan. Results Fifty out of 55 patients were recruited (response rate?=?90.9%). A total 26/50 (52.0%) went for a bone mineral density scan, none were osteoporotic, 17/50 (34%) were osteopenic, 2/50 (4.0%), were started on osteoporosis medications and 14/50 (28%) modified their lifestyle to improve bone health or started on calcium supplements. Osteoporosis knowledge significantly increased from baseline to month two (46.3?±?21.4 vs. 79.1?±?14.3, p?<?0.001). Patients had a satisfaction score of 89.8?±?12.4. Follow-up rates were 83.9% and 100% at months 1 (BMD appointment) and 2 (phone follow up), respectively. The intervention was successfully coordinated. Data entry was determined to be viable based on the researchers’ experience. Conclusion The interprofessional collaborative osteoporosis screening programme was found to be feasible in Malaysia.

     

Medicine taking behaviours of people with type 2 diabetes in Indonesia: a qualitative study

International Journal of Clinical Pharmacy - Background Medicine-taking behaviour of people in Indonesia is particularly complex because of Indonesia’s pluralistic health system, in which...     

The Bulle: Support and Prevention of Psychological Decompensation of Health Care Workers During the Trauma of the COVID-19 Epidemic

The coronavirus disease 2019 pandemic presents unprecedented challenges for the health care system. The pressure on health care staff continues to intensify, accentuated by the confinement (lockdown) of the population and the unprecedented duration of this emergency. Separately and especially together, overwork, degraded conditions of care because of the never-ending emergency, and the risk of exposure to the virus can lead to acute psychological distress or signs of burnout.This original program was developed at Cochin Hospital in Paris, France to prevent these potentially dramatic psychological consequences, support the medical staff, and identify those most affected to offer them specific care. A program and a space for relaxation and support for hospital caregivers by hospital caregivers, the Port Royal Bulle (the Bubble) offers these workers help in decompression and relaxation. It combines a warm and caring welcome that promotes attention, listening, conversations, and exchanges as needed, empathetic support, and the ability to participate in soothing, relaxing, or low-impact physical activities. It takes care of caregivers. The Bubble is a program that is simple to set up and that appears to meet professionals' expectations. Making it permanent and enlarging its scale, as a complement to existing programs, might help to support health care personnel in their work.