Patients' independence of a nurse for the administration of subcutaneous anti-TNF therapy: A phenomenographic study.

Rheumatology nursing supports patients to manage their lives and live as independently as possible without pain, stiffness and functional restrictions. When conventional drugs fail to delay the development of the rheumatic disease, the patient may require biological treatment such as self-administered subcutaneous anti-tumour necrosis factor (TNF) therapy. It is therefore important that the patient perspective focuses on the life-changing situation caused by the administration of regular subcutaneous injections.

Chronic musculoskeletal pain predicted hospitalisation due to serious medical conditions in a 10 year follow up study.

Background: The aim was to examine if self reported chronic regional pain (CRP) and chronic widespread pain (CWP) predicted inpatient care due to serious medical conditions such as cerebrovascular diseases, ischemic heart diseases, neoplasms and infectious diseases in a general population cohort over a ten year follow-up period.

Methods: A ten-year follow up of a cohort from the general adult population in two health care districts with mixed urban and rural population in the south of Sweden, that in 1995 participated in a survey on health and musculoskeletal pain experience. Information on hospitalisation for each subject was taken from the regional health care register.

Gallstone disease in the elderly: are older patients managed differently?

Background: This study aimed to describe the differences in the management of symptomatic gallstone disease within different elderly groups and to evaluate the association between older age and surgical treatment.

Methods: This single-institution retrospective chart review included all patients 65 years old and older with an initial hospital visit for symptomatic gallstone disease between 2004 and 2008. The patients were stratified into three age groups: group 1 (age, 65-74 years), group 2 (age, 75-84 years), and group 3 (age, ≥ 85 years).

Do gastrotomies require repair after endoscopic transgastric peritoneoscopy? A controlled study.

Background: The optimal method for closing gastrotomies after transgastric instrumentation has yet to be determined.

Objective: To compare gastrotomy closure with endoscopically delivered bioabsorbable plugs with no closure.

Design: Prospective, controlled study.

A taxometric investigation of the latent structure of worry: dimensionality and associations with depression, anxiety, and stress.

Worry has been described as a core feature of several disorders, particularly generalized anxiety disorder (GAD). The present study examined the latent structure of worry by applying 3 taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from 2 large samples. Worry in the first sample (Study 1) of community participants (n=1,355) was operationalized by worry engagement, absence of worry, and the worry feature of trait anxiety.

Late effects of early growth hormone treatment in Down syndrome.

Objective: Down syndrome (DS) is associated with short stature and psychomotor delay. We have previously shown that growth hormone (GH) treatment during infancy and childhood normalizes growth velocity and improves fine motor skill performance in DS. The aim of this study was to investigate late effects of early GH treatment on growth and psychomotor development in the DS subjects from the previous trial.

Patients' perceptions of drug information given by a rheumatology nurse: a phenomenographic study.

Background: Pain, stiffness and functional restriction of the joints are the main problems experienced by patients with inflammatory rheumatic conditions. The majority of patients with rheumatic diseases require several drugs every day. Adherence is highest among patients who have repeatedly been given drug information by a nurse from the start of the treatment.

Hemodialysis in hypotensive heart failure using midodrine.

Background: Dialysis in patients with severe congestive heart failure and low blood pressure is difficult even in a hospital setting. We retrospectively recorded the effects and usefulness of an alpha (1) agonist in an outpatient dialysis unit in 5 patients with end-stage renal disease with symptomatic heart failure and low blood pressure. To provide outpatient dialysis, they were given midodrine before and during their dialysis sessions.

Perception of multimodal cognitive treatment for people with chronic widespread pain--changing one's life plan.

Purpose: The aim of this study was to gain a deeper understanding of chronic widespread pain patients' perception of a multimodal treatment with a cognitive approach.

Methods: A reformulated grounded theory study based on interviews with 16 participants in the programme was conducted at the end of a 6-month treatment period.

Results: The result describes a conceptual model of the informants' perception of the treatment.

Fine-needle aspiration biopsy of chondromyxoid fibroma: an investigation of four cases.

We describe the cytologic features of chondromyxoid fibroma in fine-needle aspiration biopsy specimens in 4 patients. We analyzed rapid Romanowsky- and Papanicolaou-stained slides with a respect to overall cellularity, the presence of hypercellular chondromyxoid fragments (HCFs), nuclear atypia, cytoplasmic features, and the presence of giant cells. The most consistent and diagnostically useful feature was the presence of HCFs, which were present in all 4 cases.

Transoral incisionless fundoplication for gastroesophageal reflux disease in an unselected patient population.

Background: EsophyX is an endolumenal approach to the treatment of gastroesophageal reflux disease (GERD). This report describes one of the earliest and largest North American experiences with this device.

Methods: Prospective data were gathered on consecutive patients undergoing EsophyX fundoplication for a 1-year period between September 2007 and March 2009.

Population-based waist circumference and waist-to-height ratio reference values in preschool children.

Aim: To establish new reference values for measurements of waist circumference and waist-to-height ratio in preschool children.

Methods: A population-based, cross-sectional study of 4502 children aged 0-5 years derived from child health care in a Swedish county. Measurements of weight, height and waist circumference were recorded using a standardized procedure.

Penetrance of marked cognitive impairment in older male carriers of the FMR1 gene premutation.

Background: Male carriers of the FMR1 premutation are at risk of developing the fragile X-associated tremor/ataxia syndrome (FXTAS), a newly recognised and largely under-diagnosed late onset neurodegenerative disorder. Patients affected with FXTAS primarily present with cerebellar ataxia and intention tremor. Cognitive decline has also been associated with the premutation, but the lack of data on its penetrance is a growing concern for clinicians who provide genetic counselling.

Fine needle aspiration biopsy of metanephric adenoma: a case report.

Background: Metanephric adenoma (MA) is a rare, benign renal neoplasm. Only 3 previous case reports describe the fine needle aspiration biopsy (FNAB) cytologic features of MA. Regarding treatment, radioflrequency ablation (RFA) is an emerging alternative to surgical resection of renal neoplasms in appropriately selected patients.

Patients' conceptions of the cause of their rheumatoid arthritis: a qualitative study.

Background: Patients' perspective of the causes and consequences of rheumatoid arthritis (RA) can conflict with that of healthcare professionals and lead to misunderstanding, difficulties in management and a poorer outcome.

Objectives: The aim of this study was to describe the variation in how patients conceive the cause of their RA.

Methods: An open written question from the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study, aimed at patients recently diagnosed with RA, was answered by 38 strategically selected patients during 2003 and analysed using the phenomenographic approach.

Metastatic calcification involving the true vocal cord.

Metastatic calcification (MC) commonly results secondary to phosphorus and calcium dysregulation in end-stage renal disease (ESRD). Only once before has MC been reported to involve a true vocal cord. A 35-year-old man with ESRD and secondary hyperparathyroidism was evaluated for hoarseness.

Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain.

Background: Many factors are proposed to be associated with health-related quality of life. Knowledge of health factors associated to development of a good health-related quality of life could be of use in clinical practice and public health work. The aim of this study was to investigate the associations between suggested health factors and health-related quality of life at baseline and in an eight-year follow up in subjects with and without chronic musculoskeletal pain in a cohort from a general population.

Transgastric endoscopic peritoneoscopy does not require decontamination of the stomach in humans.

Introduction: Natural orifice translumenal endoscopic surgery (NOTES) is a rapidly evolving field that provides endoscopic access to the peritoneum via a natural orifice. One important requirement of this technique is the need to minimize the risk of clinically significant peritoneal contamination. We report the bacterial load and contamination of the peritoneal cavity in ten patients who underwent diagnostic transgastric endoscopic peritoneoscopy.

Assessing the impact of the trauma team training program in Tanzania.

Background: In sub-Saharan Africa, injury is responsible for more deaths and disability-adjusted life years than AIDS and malaria combined. The trauma team training (TTT) program is a low-cost course designed to teach a multidisciplinary team approach to trauma evaluation and resuscitation. The purpose of this study was to assess the impact of TTT on trauma knowledge and performance of Tanzanian physicians and nurses; and to demonstrate the validity of a questionnaire assessing trauma knowledge.

Natural orifice translumenal endoscopic surgery.

This article provides an overview of the currently available animal data on natural orifice translumenal endoscopic surgery (NOTES) on the topics of translumenal access and closure, iatrogenic intraperitoneal complications, especially infection and overinsufflation, spatial orientation, and the development of enabling technologies. Human trials to date are also reviewed and discussed.

Another model for giving.

Most of the global healthcare issues facing us--from expanding access to care, to providing medical and dental care in the aftermath of disasters--are far too complex for any single sector to successfully solve. Industry, the healthcare profession, government, academia and non-governmental organizations (NGOs) are all limited in their scope and their ability to effectively address the necessary challenges of these multifaceted issues. It is only though public-private partnerships, in which the participants contribute resources and skills for which they individually are best suited, that true progress can be made in affecting change.

Patients' dependence on a nurse for the administration of their intravenous anti-TNF therapy: A phenomenographic study.

Background: Pain, stiffness and functional restriction of the joints are the main problems for many patients with inflammatory rheumatic conditions. When conventional drugs fail to delay the development of the disease, the patient may require biological treatment such as anti-TNF therapy. Some biological drugs are administered in the form of intravenous infusions and thus the patient is obliged to attend a clinic in order to receive his/her medication, which can affect everyday life as well as independence.

Endolumenal fundoplication with EsophyX: the initial North American experience.

EsophyX is a novel endolumenal therapeutic option for the treatment of gastroesophageal reflux disease (GERD). The device is passed into the stomach, where it deploys a series of full-thickness fasteners to create a neogastroesophageal valve. The objective of this study was to demonstrate the safety and characterize the effectiveness of this approach in the initial North American experience.