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Case Study: Stroke and Diaphragmatic Palsy leading to Pneumonia 案例研究:中风和膈肌麻痹导致肺炎
International Journal of User-Driven Healthcare Pub Date : 2014-07-01 DOI: 10.4018/IJUDH.2014070104
A. Shrikhande, T. Galvez, Nicolas Langendorfer, K. Jain, Rakesh Biswas
{"title":"Case Study: Stroke and Diaphragmatic Palsy leading to Pneumonia","authors":"A. Shrikhande, T. Galvez, Nicolas Langendorfer, K. Jain, Rakesh Biswas","doi":"10.4018/IJUDH.2014070104","DOIUrl":"https://doi.org/10.4018/IJUDH.2014070104","url":null,"abstract":"The authors discuss the clinical complexities surrounding an 85-year-old male complaining of left sided weakness for one month, along with cough and fever for 20 days. Findings on non-contrast CT scan of the brain showed an acute-on-chronic infarct in the right parietal region, in the territory of the right middle cerebral artery, with lacunar infarct in the left thalamus. A chest radiograph showed a heterogeneous opacity in the right lower zone, and air bronchogram with an elevated right dome of the diaphragm. The patient was diagnosed to have suffered a stroke with a subsequent right-sided pneumonia due to diaphragmatic palsy. The patient was put on ventilator and further supportive management was instituted. This article presents the clinical course of the case and the experiential learning associated with it.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120952173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Case Study: Atypical Presentation of Orbital Hemangiopericytoma 病例分析:眼眶血管外皮细胞瘤的不典型表现
International Journal of User-Driven Healthcare Pub Date : 2014-07-01 DOI: 10.4018/IJUDH.2014070107
V. Damle, R. Agarwal, N. Garg, H. Gulwani
{"title":"Case Study: Atypical Presentation of Orbital Hemangiopericytoma","authors":"V. Damle, R. Agarwal, N. Garg, H. Gulwani","doi":"10.4018/IJUDH.2014070107","DOIUrl":"https://doi.org/10.4018/IJUDH.2014070107","url":null,"abstract":"Hemangiopericytoma is a slow growing, vascular mesenchymal tumor, which may behave like a malignant tumor, leading to local recurrence, or metastasis, or both. This report is about a 32-year-old lady with non-axial proptosis and diminished vision due to a mass lesion in the superomedial quadrant of the right orbit. CT scan and MRI reports showed no intracranial extension. Surgical intervention was done through the roof of the orbit keeping hemangioma, neuroma or schwannoma as the leading differential diagnoses; however, on aspiration, it was not bleeding. It was confirmed to be a hemangiopericytoma on histopathological examination. The unique presentation, where, on tapping, no blood was found, makes this case an example of diagnostic dilemma. This lack of bleeding might be due to vascular insufficiency of the mass. Proptosis disappeared the following day after the surgery and vision also showed significant improvement to 20/20 within a week after surgery. The patient has been kept on regular follow up keeping in mind the recurrent and metastatic behavior of the tumor.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131696495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Case Study: Glaucoma and Epidemic Dropsy - A Past Possible Association Revisited 案例研究:青光眼和流行性水肿-过去可能的联系
International Journal of User-Driven Healthcare Pub Date : 2014-07-01 DOI: 10.4018/IJUDH.2014070105
S. Gupta, D. Verma, D. Singh
{"title":"Case Study: Glaucoma and Epidemic Dropsy - A Past Possible Association Revisited","authors":"S. Gupta, D. Verma, D. Singh","doi":"10.4018/IJUDH.2014070105","DOIUrl":"https://doi.org/10.4018/IJUDH.2014070105","url":null,"abstract":"Epidemic dropsy is a multi-system disease involving the cardiovascular, hepatic, renal, ocular and other systems. Onset is usually subacute or insidious with watery diarrhea and vomiting. This lasts from a few days to more than a week. Bilaterally symmetrical pitting edema of the lower limbs extending from the ankles up to the scrotum and abdominal wall is a constant feature. It is a toxic disease caused by the unintentional ingestion of Argemone mexicana (prickly yellow poppy) seeds as an adulterant of wheat flour, or more commonly, of cooking oil such as mustard oil. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids of Argemone oil. It is a rare phenomenon for practicing ophthalmologists to observe cases of epidemic dropsy, and the possibility of glaucoma should be kept in mind in cases of epidemic dropsy, when members of same family or village report with raised IOP, pedal edema and history of use of mustard oil for cooking or massage. Glaucoma is hypersecretory in nature; prostaglandin and histamine release may have significant roles in its pathogenesis. The disease has self limiting course but needs good control of intraocular pressure (IOP) medically till it returns to normal and visual field changes have stabilized. Its early diagnosis is very important to prevent grievous complications; hence, all cases should be followed up regularly for IOP measurement and visual field analysis up to 8-12 weeks, because, if ignored, optic atrophy may develop.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122374968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Perspectives: Fourteen Aphorisms - From Problem Solving to Relationship Building 观点:十四句格言——从解决问题到建立关系
International Journal of User-Driven Healthcare Pub Date : 2014-07-01 DOI: 10.4018/IJUDH.2014070101
P. Shankar
{"title":"Perspectives: Fourteen Aphorisms - From Problem Solving to Relationship Building","authors":"P. Shankar","doi":"10.4018/IJUDH.2014070101","DOIUrl":"https://doi.org/10.4018/IJUDH.2014070101","url":null,"abstract":"Dr. David Loxterkamp has been practicing as a primary care physician for over thirty years in Belfast, Maine, United States of America. He is a frequent writer on issues related to primary care and has recently published a book titled ‘What matters in medicine; Lessons from a life in primary care'. Towards the middle of the book he puts forward fourteen aphorisms for physicians with special relevance for primary care practice. In this manuscript the author briefly examines these aphorisms and describes their profound possible influence on modern medical practice, healthcare and medical education. The author is of the opinion that Dr Loxterkamp's observations and concepts born from and honed by over thirty years of practice as primary care physician in Belfast, Maine, United States should be read by all physicians and especially by medical students in training.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"104 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113991791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Vascular System: Unblocking Conduits to Our Rivers Within 血管系统:畅通通往我们体内河流的管道
International Journal of User-Driven Healthcare Pub Date : 2014-04-01 DOI: 10.4018/IJUDH.2014040104
P. Chatterjee, A. Das, Carmel M Martin, A. Basu, R. Biswas
{"title":"The Vascular System: Unblocking Conduits to Our Rivers Within","authors":"P. Chatterjee, A. Das, Carmel M Martin, A. Basu, R. Biswas","doi":"10.4018/IJUDH.2014040104","DOIUrl":"https://doi.org/10.4018/IJUDH.2014040104","url":null,"abstract":"The motivation for this paper is based on the assumption that certain patient and health professional users' experiences can serve as a mirror or a model, whether positive or negative, for other patients and health professional users/learners. This narrative presents a patient's experience of his complicated and ad hoc journey through the diagnoses and treatment of his vascular system disorder. It then tries to connect this with health professional opinions and other patient experiences toward the collective goal of ‘getting a proper diagnosis and management of vascular disease.' Interspersed are professional narratives in the form of clinical evidence and expert comments towards clinical problem solving around vascular system disorders. User-driven health care implies shared decision making based upon collaborative partnerships between patients and health professionals. This narrative indicates that power imbalances in knowledge, particularly when the patient is ill and vulnerable, can lead to inappropriate and even harmful treatments, when profit appears to be the main driver of the medical industrial complex.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121708831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Role Plays Used During A Humanities In Medicine Module: Selected Transcripts Part 2 角色扮演中使用的人文医学模块:选定的成绩单部分2
International Journal of User-Driven Healthcare Pub Date : 2014-04-01 DOI: 10.4018/IJUDH.2014040103
R. Shankar, Kundan Singh, A. Shakya, A. Dhakal, R. Piryani
{"title":"Role Plays Used During A Humanities In Medicine Module: Selected Transcripts Part 2","authors":"R. Shankar, Kundan Singh, A. Shakya, A. Dhakal, R. Piryani","doi":"10.4018/IJUDH.2014040103","DOIUrl":"https://doi.org/10.4018/IJUDH.2014040103","url":null,"abstract":"A medical humanities (MH) module has been conducted at KIST Medical College, Lalitpur, Nepal for the last four years. The students are divided into small groups and case scenarios, role-plays, paintings and activities are used to explore MH. The module for the fourth batch was conducted from December 2011 to March 2012. In this article the authors provide a brief overview of the MH module, Sparshanam and the learning objectives of different sessions. They provide transcripts of certain role plays conducted during the fourth, fifth and sixth sessions of the module. The role plays were conducted in Nepali with the help and guidance of the facilitators and the written transcripts in English language were provided by different student groups.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128096674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Single Case Studies as Seeds: Brain Models That Matter 作为种子的单一案例研究:重要的大脑模型
International Journal of User-Driven Healthcare Pub Date : 2014-04-01 DOI: 10.4018/IJUDH.2014040105
A. Price
{"title":"Single Case Studies as Seeds: Brain Models That Matter","authors":"A. Price","doi":"10.4018/IJUDH.2014040105","DOIUrl":"https://doi.org/10.4018/IJUDH.2014040105","url":null,"abstract":"Single case studies are research studies of single participants. They explore new ideas and can suggest extensions in methods and for treatment (Yin, 1984). In this article the case study refers only to conditions observed and is limited to what was observed from these comparisons between normal function and patterns of specific conditions. This does not reflect the theory of a formal case study but rather it is an attempt to show the case study and simple computer modelling as learning tools in a complex environment. Critics of case study methodology cite small case numbers as not having grounds for establishing reliability or generalization of findings and that the intensity of exposure needed for thorough case studies could bias the research findings subtracting from researcher objectivity. Early computer models were used to simulate the function of the brain and provide partial answers. They provided insight into the understanding of complex function. In recent history, computer models and case studies have been cast aside in favor of live brain imaging and complex biochemical reactions. It is good to remember that these tools brought us to the place of knowledge we enjoy today and have enlarged diagnostic and treatment choices. They are still valuable and inexpensive methods that can impact the imaginations of neuroscientists and kindle their passions to solve the complexities of the human mind one problem at a time. Greater rigor can be easily maintained by adopting a format whereby a patient would be assessed by a fully standardized neuropsychological battery and the performance then compared to large sample of normative data. The formal study is important for generalization of findings across conditions and can be applied once normative data has been collected as a basis for comparison.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132738912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
eICU STUDY: A Proof of Concept eICU研究:概念验证
International Journal of User-Driven Healthcare Pub Date : 2014-04-01 DOI: 10.4018/IJUDH.2014040101
A. Dhakal, B. Dhakal, L. Pathak, Shadi Marina, V. Vijayaraghavan
{"title":"eICU STUDY: A Proof of Concept","authors":"A. Dhakal, B. Dhakal, L. Pathak, Shadi Marina, V. Vijayaraghavan","doi":"10.4018/IJUDH.2014040101","DOIUrl":"https://doi.org/10.4018/IJUDH.2014040101","url":null,"abstract":"The authors' objective is to study the effect of eICU (electronic ICU) as a supplementary remote intensive care program on improvement in clinical outcomes. The experiment is designed to determine the clinical usefulness before and after evaluation of the effects of eICU program. The setting is two adult ICU of a large 375 bed teaching community hospital in US. The study was undertaken by group of resident physicians after eICU was started to study the impact on few selected parameters in a teaching hospital. A total of 2537Patients admitted to ICU between June 2006 to June 2008 (n= 1310 before and n= 1227 after implementation of the eICU) The eICU Program used intensivists and other healthcare providers to give 24x7 supplemental monitoring and management from a remote location. Supporting software and computer based decision support tool were available. The outcome is to study and compare rate of falls, mortalities, incidence of code blues and length of stay between the two periods before and after the implementation of eICU. In the results no statistical difference was observed in the studied parameters thus showing contrary results to other previous studies. The incidence of code blue (39 vs. 54 with P value of 0.36), length of stay (3.0 vs. 3.1 P value 0.36), mortality rates (77 vs. 90 P value 0.28) and incidence of fall (0 vs. 1 P value 0.28) all show no improve outcomes before and after the implementation of eICU.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126495362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
“Paper Teachers:”: Towards a True Postgraduate Education “纸质教师”:走向真正的研究生教育
International Journal of User-Driven Healthcare Pub Date : 2014-04-01 DOI: 10.4018/IJUDH.2014040106
D. Elpern
{"title":"“Paper Teachers:”: Towards a True Postgraduate Education","authors":"D. Elpern","doi":"10.4018/IJUDH.2014040106","DOIUrl":"https://doi.org/10.4018/IJUDH.2014040106","url":null,"abstract":"","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123613641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Self-Management System for Chronically Ill Patients 慢性病患者自我管理系统
International Journal of User-Driven Healthcare Pub Date : 2014-04-01 DOI: 10.4018/IJUDH.2014040102
Silvia Torsi
{"title":"A Self-Management System for Chronically Ill Patients","authors":"Silvia Torsi","doi":"10.4018/IJUDH.2014040102","DOIUrl":"https://doi.org/10.4018/IJUDH.2014040102","url":null,"abstract":"This article describes the User Centered Design Process for providing chronically ill patients tools to better self-manage their conditions. Stroke, congestive heart failure and chronic pain are complex conditions in which regulated physical activity can provide real improvement of symptoms and health conditions. In particular the work is focused on how the authors gathered the guidelines from the patients, how they translated them into interface design and how did the patients react to the paper prototypes. Paper prototyping is a quick, inexpensive and easily modifiable way to create intermediate artifacts that can be iteratively modified by early evaluation with intended users.","PeriodicalId":211533,"journal":{"name":"International Journal of User-Driven Healthcare","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127225042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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