...The rhythm disturbances were also maximum in this age group. The minimum incidence of myocardial infarction was in the age group 20 to 29 years. The oldest patient was 85 year old male. The youngest patient was 23 year old male. Table: 4 Incidences of Rhythm Disturbances In patients With Various Risk Factors In Acute MI Risk Factors Patient with Patient with Rhythm p MI Disturbances value (Total =100) No. of No. of percentage Patients Patients Smoking 57 38 66.7 0.0000 Diabetes 55 37 67.3 0.0000 Hypertension 38 23 60.5 0.0225 Alcohol 33 25 75.8 0.0000 Hypercholesterolemia 51 19 37.3...
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...Multivariate Analysis of Risk Factors for Death Following Gastric Bypass for Treatment. I chose this article, because I did have this surgery done with no complications, and it is also a fascinating procedure and hope to one day work in this area. Pre operative mortality is the most feared outcome of bariatric surgery, it is reported to happen between 0.5 ad 1.5% of patients. In this article it identifies mortality fore either open or laparoscopic Roux-en-y bypass. The database is from Virginia Commonwealth university and was queried for patients who had undergone either an open gastric bypass (O-GBP) or a laparoscopic gastric bypass (L-GBP). A multivariate logistic regression analysis to identify factors related to perioperative mortality was performed. The factors examined included was age, gender, body mass index, preoperative weight, hypertension, diabetes mellitus, sleep apnea, obesity hypoventilation syndrome, venous 3. Analysis of a Research Report Article stasis ulcers, intestinal leak, small bowel obstruction, and pulmonary embolus. The data was found to find independent factors related to early death. Early death was defined as death that occurs within 30 days of the initial procedure or as a direct result of a complication of the original procedure (Annals of Surgery p3). In this article tables were used to compare demographic information of the O-GBP and L-GBP groups. The O-GBP has a higher incidence of male gender and heavier patients. Except for diabetes...
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...One of the main risk factors associated with individuals that have atrial fibrillation is stroke. While anticoagulants can help with this associated risk, not all patients with atrial fibrillations are at risk of developing a stroke. This can be an issue for some patients as taking anticoagulants can lead to other issues like bleeding. With that in mind, there is a scoring system in place called CHA2DS2-VASc, that help determine if a patient may require anticoagulant therapy. 1 This scoring system is broken down into seven risk factors that are assigned a specific score. These risk factors are then summed up to a possible maximum score of 9; higher scores suggest a higher risk of stroke. The seven risk factors are Congestive heart failure,...
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...Prevalence of dementia in elderly patients with hip fracture.PUBMED.GOV Hip fractures occur commonly and are a cause of disability for older adults and lead to increased dependence and requirements for social support. Dementia is one of the possible risk factors for falling and hip fracture, a potential source for complications during surgery and during the postoperative period, difficulties in rehabilitation and a risk factor for hip fracture reccurence. However, in previous studies of hip fracture patients, cognitive status has not been formally assessed during the inpatient stay and diagnosis was based only on previous history. Additionally, no previous studies have compared prevalence of dementia between elderly patients with hip fracture and patients with other surgical pathology. Our aim was to define whether dementia was more prevalent in older subjects with hip fracture than in other elderly patients undergoing surgery. In this study, we prospectively assessed all patients aged 68 and older admitted to our hospital for hip fracture surgery during a one year period and compared them with age and gender matched patients attending other surgical departments. 80 hip fracture patients and 80 controls were assessed for dementia. Dementia was common in both groups, presumably reflecting the advanced mean age of both groups and cognitive deterioration due to hospitalization-status. Dementia was significantly higher in the hip fracture group (85%) compared to the control group...
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...providers perform inhalational inductions with Sevoflurane to pediatric patients on a daily basis with intravenous cannulation following the induction. It is common practice for the majority of pediatric patients enduring medical procedures to undergo this routine in order to be anesthetized (Joshi et al., 2012). The incidence of laryngospasms occurring...
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...injury and death by injury in adults over the age of 65 years (Lee, 2013, p.37). Falls can have devastating results in the geriatric population. Fear of falling is a defined geriatric syndrome that may contribute to further functional decline in an already frail patient. When people experience something unpleasant, their natural response is an aversion to that experience. People may begin to limit their activities after a fall or as they become weaker and less agile with increasing age. This leads to a more sedentary lifestyle and physical atrophy, which further predisposes them to falls (Lee, 2013, p.37). According to Al-Aama (2011): A fall is a complex multifactorial phenomenon. In order to understand the mechanism of falls, it is essential to understand the prerequisites of normal gait. Essential substrates for a normal gait include fine neural networks such as the cortical–basal ganglia loop and the basal ganglia–brainstem system, exquisite musculoskeletal structures with appropriately regulated muscle tone, and proper processing of sensory information (p. 772). A fall in the geriatric population could be the result of various long-term or short-term factors. A short-term factor could include an acute illness or an adverse drug reaction. Normal gait and balance requires freely moving joints; muscles contracting at the right time with the appropriate strength; and accurate visual, vibratory, and proprioceptive input. As patients age, they may experience stiffened joints, decreased...
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...Nascha Kayani is 83 years old female who is a resident of Bitter Water Clan from Navajo Reservation. Her grandson Ahiga emailed yesterday stating that Nascha was suffering from severe pain in her left hip. Her grandson stated that the patient lives in a sedentary lifestyle of Navajo. There is not any other problem stated. The patient is 165 pounds with BMI 29.2. There is not any past medical history included according to the data given by her grandson. According to the data provided, the patient does not consume alcohol due to restriction in Navajo but she is a smoker. The patient is currently living in her Hogan. In Navajo, people are living under virtual isolation. So, it is difficult to contact patient directly from the phone to get more information. The only way to contact her is to contact her grandson and he will relay the information. As Nascha is from registered tribe, this makes her eligible for care at an Indian Health Service. For Nascha to arrive at the hospital, she will have to make arrangements for her travelling. She could make it to the hospital if there is no rain. Her grandson need to translate the English for Navajo because the people in Navajo cannot understand English including the patient. The vital statistics of the patient is as following: Vital Statistics: Nascha Kayani Blood Pressure 140/88...
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...organ. I was given the task of deciding who would receive a liver from a list of four potential recipients in an imaginary scenario. The four patients all have a rare tissue type and it is unlikely that another liver will be available that will match for months or even years. Patient number one is a 65-year-old male with four adult children whose wife depends on him for care of a debilitating illness. His liver was damaged by cirrhosis due to alcoholism. Patient number two is a 35-year-old female who is married with two small children. Her liver damage was caused by a chronic illness. Patient number three is a 21-year-old single male whose liver was damaged by a Tylenol overdose. Patient number four is a 28-year-old female who is married with 5 children under the age of 10. She is an illegal immigrant farm worker whose liver was damaged due to exposure to a chemical that was sprayed on the crops where she works. Very little information was given on each person. The first piece of information that would be a real deciding factor for me that was not mentioned was how compliant each patient would be with medical treatments. Without knowing this, it is very difficult to try to predict outcomes after surgery. So, given the little information that I have, here is how I came up with my decision. I decided to eliminate patient number one right off the bat. I realize that...
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...aneurysmal ruptures. The study model used in this investigation (case-control) is readily suitable to study uncommon diseases with low overall prevalence rates. However, given the impact such a condition could have on a population segment thought to have many years of productivity – and because of promising animal studies – the study was deemed beneficial as an initial step toward learning more about the drug’s beneficial indicators. The primary endpoint of focus was the likelihood of the rupture of an aneurism and the protective effect of statins on reducing that outcome. According to the authors (Yoshimura, Murakami, et al), their results showed that use of any statin “was inversely associated with rupture risk in unruptured aneurysm patients.” This finding was qualified because of a number of limitations associated with their model and techniques. Our recommendation seeks to address some of these concerns. The...
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...(NCDs) risk factors for Malaysia are obtained primarily through the National Health and Morbidity Surveys (NHMS), conducted by the Ministry of Health (MOH). This population-based survey was first conducted in 1986, and was then repeated every 10 years. However, to monitor the changing trends of NCD risk factors, 10 years was too infrequent. Therefore, starting in 2011, the implementation of NHMS was revised whereby for NCD risk factors, NHMS will be conducted every four years. The results of the latest NHMS (in 2011) that covered NCD risk factors was published in March 2012, and the NHMS Conference was held on 13 June 2012 in Holiday Villa Hotel, Subang Jaya, Selangor. PREVALENCE OF DIABETES IN MALAYSIA NHMS 2011 has shown that the prevalence of diabetes in Malaysia has increased 31 per cent in the space of just five years, from 11.6 per cent in 2006 to the current 15.2 per cent. This means that there is currently about 2.6 million adults age 18 years and above living with diabetes. This increase was mostly contributed by the increased proportion of “undiagnosed diabetes”, from 4.5 to 8 per cent. As you can see on the graph (Figure 1), for every single individual diagnosed, another individual is undiagnosed. The prevalence of “impaired fasting glucose” has also risen, from 4.2 per cent in 2006 to 4.9 per cent in 2011. Figure 2 shows the prevalence of diabetes by age groups. The graph shows a steep increase after age 30, and reaches a peak at the 60 to 64 years age group. In...
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...dissatisfaction in the health care setting. We reviewed several scholarly sources and withdrew pertinent information. Following the discussion of literature findings is a summary including suggestions for further research. In the article written by Fletcher, job satisfactions as well as dissatisfactions were investigated. Questionnaires were mailed to 5,192 registered nurses (RNs), 1,780 of which were returned and scored using several evaluation methods (Fletcher, 2001). Researchers looked at job satisfaction, patient satisfaction and safety, extrinsic work values, role of the immediate supervisor, and intent to stay in nursing. Job satisfaction was evaluated on several levels: Profits, Job performance, Intrinsic work values, and, Patient care issues. Profits referred not to personal financial gain, but to the organization’s profits. Many nurses responded feeling "devalued in their job" (Fletcher, 2001), and resentful of "the perceived placing of profits over patients…" (Fletcher, 2001). Job Performance was not only applied to themselves, but attitudes and performance of co-workers on a horizontal and vertical plane were also considered. Many held expectations of fellow employees to a high standard and "…were frequently...
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...Tangela Hales April 5, 2012 Correlational Critique Criterion Critique 1. General Overview of the research. (5 points) The purpose of the Tang et al, (2009) study was to examine fatigue in chronic heart failure patients and its related factors. The aim was to (1) examine the associations among age, gender, New York Heart Association classification (NYHA), Ejection Fraction (EF), beta-blocker use, Hemoglobin (Hb), depression and fatigue in patients with Congestive Heart Failure (CHF) and (2) determine the contribution of physiological and psychological factors to the variance in CHF patients’ fatigue. Fatigue is a common symptom in patients with chronic heart failure, but little is known about this phenomenon. Fatigue for this sample of chronic heart failure patients was significantly predicted by depression, EF, and NYHA. 2. Are the major variables identified and defined conceptually and operationally? Identify the variables of the study and specify their level of measurement (nominal, interval, ordinal, and ratio). ( 5 points) Yes, the major variable was identified and defined conceptually and operationally. The main outcome variable is fatigue, which is the dependent variable. Conceptual definition: Fatigue- A complex, multifaceted subjective feeling, which involves physical, psychological and activity dimensions. Operational definition: Fatigue- A common symptom seen with CHF. Fatigue is multidimensional, and was measured by two scales: Lee’s Fatigue Visual...
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...Cancer: Who's at Risk? Historically, most of the patients are above 40 years of age at the time of discovery of oral cancer. Aging is an important factor because the immunity diminishes with age as well as there are increased chances for the cells turning from benign to malignant tumor cells. This is further supported by the fact released recently in 2008 which says that oral cancer exists even among the non smokers who are below 50 years of age. Predominantly the cause for oral cancer is attributed to the factors like the use of tobacco, consumption of alcohol and infection by Human Papilloma Virus (HPV). Among all these different causes, tobacco is considered to be the primary culprit although it takes a long time to get precipitated into an oral cancer. Especially the people who are above 50 years of age are widely affected and more than 75% of those people are constant users of tobacco. Tobacco in combination with alcohol is even more harmful and the chances are 15 times more for oral cancer if a person is addictive to both tobacco and alcohol. Recent reports also suggest that the demographics are changing rapidly as the incidence of oral cancer caused by viral infections is increasing day by day. The factors for the cause of oral cancer can be grouped as physical factors, chemical factors and biological factors. Alcohol and tobacco comes under chemical factors. Ultraviolet (UV) rays and x-rays are the major physical factors responsible for causing oral cancer. UV rays cause...
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...Epidemiology Paper In this epidemiological paper, I will be discussing about my chosen vulnerable population of elderly and the disease of type II diabetes among elderly population. I will also be discussing epidemiology and what it means, the steps and methods of epidemiology and how it was done for my chosen population and disease. Ethical and legal considerations, how to provide culturally competent care, and at last, I will discuss whether the research was descriptive or analytical, and the process of feasibility and evaluation of prevention of diseases. As stated in Nursing Standard, epidemiology is a scientific research discipline concerned with observing, measuring and analyzing health-related occurrences in human populations (Last 1995, Trichopoulos 1996). Mausner and Kramer (1985) suggest that epidemiological studies can be applied to all diseases, conditions and health-related events (Whitehead, 2000). Although epidemiology is focused on observing, measuring, and analyzing, it also evaluates diseases and health services, rationalizes resources, and prioritizes as to how to formulate strategies for health promotion. Epidemiology can also help to determine the health of the population, planning of health policies and services, and maintaining a healthy environment for all. When it comes to nursing, epidemiology offers nurses many benefits in incorporating health practices into their professional roles, helps them in having a better understanding in regards to the disease...
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...INTRODUCTION Although effects are extended in controlling the progress of a disease and restoring the well-being of patients, there are diseases which pass beyond the stage of being curable. Death is a natural occurrence in the health care setting and since nurses play a vital role in providing direct patient care, a patient’s death may bring a sense of loss and grief which could eventually affect the way health care services are appropriately and adequately provided to other patients. However, the degree of nurses’ grief as a reaction to patient death may vary in intensity. This variation may be influenced by several factors present in both the nurse and the nurse-patient relationship. This research study investigates the degree of correlation between these variables and the level of nurses’ grief, it will also look into the factors that may affect the level of grief that nurses experience upon the death of their patient. PROBLEM STATEMENT Grief is an inevitable phenomenon that every human being will eventually experience Cowles and Rodgers (1991). Base of the fact that nurses are in close contact with dying patients, they are vulnerable to the experience of grief. However, the emotional aspect of nurses’ responses to the death of their patients has barely been explored. It is opinionated that the nurse’s own emotional needs are unaddressed due to the fact that most of the studies related to patient’s death focus on the patient’s relatives and significant others. Other...
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