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1.
Nonepileptic Posttraumatic Seizures 总被引:4,自引:2,他引:2
Elizabeth Barry Allan Krumholz Gregory K. Bergey Herlene Chatha Shimellis Alemayehu Lynn Grattan 《Epilepsia》1998,39(4):427-431
Summary: Purpose: Epileptic posttraumatic seizures (PTSs) are a well-recognized consequence of head injury (HI), but HI and nonepileptic seizures (NESs) have not been related. We describe a significant subset of patients with NESs who had their seizures attributed to HI.
Methods: We reviewed the records of all patients diagnosed with NES at the University of Maryland Medical Center over a 6-year period (1989–1995) and selected patients with seizures attributed to a head injury occurring ≥3 years before the onset of their seizures.
Results: Of 157 patients with video-EEG confirmed NES, 37 (24%) had the onset of their seizures attributed to an HI. Their average age was 34 years (range, 15–56 years); 68% were women. Nonepileptic PTS usually developed within the first year after HI (89%). Convulsive symptoms were present in 54%. Whereas epileptic PTSs characteristically follow severe HI, the majority (78%) of our patients with nonepileptic PTSs sustained only mild HI. Before their HI, 76% of our patients were employed, working in the home, or students, but only 11% could continue those activities after developing nonepileptic PTSs.
Conclusions: Nonepileptic PTSs are frequently mistaken for epileptic PTSs and result in serious disability. The misdiagnosis of nonepileptic PTSs leads to ineffective and inappropriate treatment. Patients with intractable seizures after HIS, articularly mild HIS, should be carefully evaluated for NESs. 相似文献
Methods: We reviewed the records of all patients diagnosed with NES at the University of Maryland Medical Center over a 6-year period (1989–1995) and selected patients with seizures attributed to a head injury occurring ≥3 years before the onset of their seizures.
Results: Of 157 patients with video-EEG confirmed NES, 37 (24%) had the onset of their seizures attributed to an HI. Their average age was 34 years (range, 15–56 years); 68% were women. Nonepileptic PTS usually developed within the first year after HI (89%). Convulsive symptoms were present in 54%. Whereas epileptic PTSs characteristically follow severe HI, the majority (78%) of our patients with nonepileptic PTSs sustained only mild HI. Before their HI, 76% of our patients were employed, working in the home, or students, but only 11% could continue those activities after developing nonepileptic PTSs.
Conclusions: Nonepileptic PTSs are frequently mistaken for epileptic PTSs and result in serious disability. The misdiagnosis of nonepileptic PTSs leads to ineffective and inappropriate treatment. Patients with intractable seizures after HIS, articularly mild HIS, should be carefully evaluated for NESs. 相似文献
2.
Leo Andrew Benedict Joseph A. Sujka Justin A. Sobrino Hanna Alemayehu Pablo Aguayo Richard Hendrickson Shawn D. St. Peter Tolulope A. Oyetunji 《Journal of pediatric surgery》2021,56(4):663-667
PurposePrevious reports in the literature demonstrate racial and ethnic disparities for children diagnosed with acute appendicitis, with minorities experiencing worse outcomes. At our institution, we have developed an evidence based patient driven protocol for children following laparoscopic appendectomy. However, the influence of such protocol on mitigating racial and ethnic disparities in outcomes remains unknown. The purpose of our study is to assess the impact of our protocol by evaluating the influence of race and ethnicity on surgical outcomes among children treated for acute appendicitis.Material and methodsA retrospective review of prospectively collected data was conducted. Children undergoing a laparoscopic appendectomy at our freestanding children's hospital between December 2015 and July 2017 were included. Demographic data, post-operative length of stay, same day discharge rates and hospital readmission rates were abstracted from patient medical records. Patients were classified by their race and ethnic background. Comparative analysis was performed in STATA with a p value < .05 determined as significant.ResultsA total of 786 children were included, with the majority being either White (70%, n = 547), Black (8%, n = 62) or Hispanic (17%, n = 133); 569 patients (72%) were found to have non-perforated appendicitis. There was no statistically significant difference in the rates of same day discharge among White, Black or Hispanic children respectively (88% vs. 77% vs. 86%, p = .126). Of the 217 children with perforated appendicitis, Hispanic children had increased rates of perforation (41%, n = 55) compared to White and Black children respectively (23%, n = 128 and 29%, n = 18, p = .001). However, average post-operative length of stay were similar among White, Black and Hispanic children (96 h vs. 95 h vs. 98 h, p = .015). On multivariate analysis, the only significant risk factor for an elevated post-operative length of stay was the presence of a perforation.ConclusionOur evidence based patient driven protocol effectively mitigates racial and ethnic disparities found in children with acute appendicitis. Further prospective investigation into the role of such patient-driven protocols to mitigate healthcare disparities is warranted.Levels of EvidenceTherapeutic study; Level 3. 相似文献
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Shavadia Jay S. Alemayehu Wendimagegn deFilippi Christopher Westerhout Cynthia M. Tromp Jasper Granger Christopher B. Armstrong Paul W. van Diepen Sean 《Journal of thrombosis and thrombolysis》2022,53(4):841-850
Journal of Thrombosis and Thrombolysis - Early prediction of significant morbidity or mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) represents an unmet... 相似文献
7.
Alemayehu?Negash Mubarek?AberaEmail author Christine?Gruber-Frank Reiner?Frank 《Child and adolescent psychiatry and mental health》2015,9(1):48
Background
Ethiopia is a country in which child and adolescent mental health needs are often not met. In order to promote capacity building, a Collaborative International Exchange Programme has been established between Jimma University at Jimma, Ethiopia, and Ludwig-Maximilian University in Munich, Germany. The programme focuses on training non-physician health professionals in mental health speciality. One of the courses in the training programme, child psychiatry, involves a child psychiatrist and a children’s nurse supporting the management of a patient described in this case report. Its conceptual framework is based on the section “significant emotional and medically unexplained complaints” of the “WHO mental health GAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings”.Objective
The purpose of this case report is to promote confidence in mental health professionals when managing patients with similar conditions, and to stimulate further evaluation of the conceptual approach in developing countries.Patient
The subject of this case report is a 14-year-old adolescent girl admitted to the psychiatric clinic at Jimma University Teaching Hospital. She was admitted for intractable retching, inability to eat, weight loss, and inability to walk. Challenges included the combination of medical and psychiatric symptoms, and the significant impairment of functioning in this adolescent. The first aim in the management of this patient was to guarantee vital functions. In a problem-oriented approach, different domains were addressed to restore nutritional, social, emotional, and motor functions. Treatment consisted of various elements of psychosocial interventions. The patient improved in 2 weeks and the final diagnosis was conversion disorder.Conclusion
Psychosocial interventions can be developed in cooperation, and applied in a setting where little child mental health expertise is available. Case-based learning relying on local expertise is suitable in meeting local needs and in developing mental health services for children and adolescents.8.
Defaulters from antiretroviral treatment in Jimma University Specialized Hospital, Southwest Ethiopia 总被引:1,自引:0,他引:1
Deribe K Hailekiros F Biadgilign S Amberbir A Beyene BK 《Tropical medicine & international health : TM & IH》2008,13(3):328-333
Objective To determine the prevalence of and factors associated with defaulting from antiretroviral treatment (ART) in Jimma, Ethiopia. Methods Unmatched case control study: cases were individuals who had missed two or more clinical appointments (i.e. had not been seen for the last 2 months) between January 2005 and February 2007; controls were individuals who had been on ART at least for 1 year and were rated as excellent adherers by the providers. Data were collected from patient records, and by telephone call and home visit to identify the reason for defaulting. Results Of 1270 patients who started ART, 915 (72.0%) were active ART users and 355 (28.0%) had missed two or more clinical appointments. The latter comprised 173 (13.6%) defaulters, 101 (8.0%) who transferred out, 75 (5.9%) who died, and 6 (0.5%) who restarted ART. Reasons for defaulting were unclear in most cases. Reasons given were loss of hope in medication, lack of food, mental illness, holy water, no money for transport, and other illnesses. Tracing was not successful because of incorrect address on the register in 61.6% of the cases. Taking hard drugs (cocaine, cannabis and IV drugs), excessive alcohol consumption, being bedridden, living outside Jimma town and having an HIV negative or unknown HIV status partner were associated with defaulting ART. Conclusion A significant proportion of patients defaulted from ART treatment. ART clinics should ensure that patients’ addresses are correct and complete. Programmatic and counseling efforts to decrease ART defaulting should address illicit drug and excessive alcohol use, decentralise ART services, institute home‐based treatment options for seriously ill and bedridden patients, and address patients concerns. 相似文献
9.
Mosquito control using insecticides has been the most successful intervention known to reduce malaria prevalence and/or incidence. However, over time success has been hampered due to the development of resistance by mosquitoes against chemical insecticides recommended for public health use. Development of effective botanical mosquitocidal compounds however can be potential alternatives tool in malaria vector control. Thus, the present study aimed at investigating the mosquitocidal effect of “Birbira” (Mellitia ferruginea) seed extract against the primary malaria vector, Anopheles arabiensis from Ethiopia. The mosquitocidal activity of M. ferruginea was assessed following WHO susceptibility test procedure. Methanol extract of M. ferruginea seeds was evaluated against third & fourth instar larvae, pupae and, non-blood fed 3–5 days old laboratory strains and field populations of A. arabiensis under laboratory condition. Mortality was then recorded after 24 h exposure. The seed extract of M. ferruginea showed high mosquitocidal activity against larvae, pupae and adult stages of both the laboratory strain and field population of A. arabiensis. The LC50 values for larvae and pupae population from a laboratory strains was, respectively, 14.7 and 41.33 mg/L. While the LC50 values for the larvae and a pupa of the field population were, respectively, 30.88 and 74.54 mg/L. In addition, the LC99 and LD99 values were also identified. The findings of this study indicated that, the extract could be applied on mosquito breeding sites. The plant extract could be also used for indoor residual sprays after conducting the persistency test. 相似文献
10.
Abraham Geremew Bezatu Mengistie Jonathan Mellor Daniele Susan Lantagne Esayas Alemayehu Geremew Sahilu 《Environmental health and preventive medicine》2018,23(1):46