1.Psychiatrists’ Perceptions Of What Determines Outcomes For People Diagnosed With Schizophrenia In Vietnam
Seiji H Humphries ; Robert J King ; Michael P Dunne ; Nguyen H Cat
ASEAN Journal of Psychiatry 2015;16(2):1-12
Objectives: Research about the outcomes of schizophrenia and the factors that
determine them in developing countries is still limited. In this study, we
interviewed experienced Vietnamese psychiatrists to examine their perspectives
on outcome determinants in their country. The qualitative approach aimed to
complement existing epidemiological knowledge and contribute to debate around
the hypothesis that recovery is better in developing countries. Methods: Fifteen
Vietnamese psychiatrists working in five leading psychiatric facilities
participated in semi-structured interviews. Thematic content analysis of their
expressed views identified three themes related to important outcome
determinants in Vietnam: access to contemporary treatment, established patientlevel
prognostic indicators, and sociocultural variables. Results: The improving
accessibility of modern treatment (including new medications, specialist staff and
facilities) and increasing community adoption of a medical perspective on mental
illness were seen as factors leading to improved outcomes, particularly in urban
areas. However, some psychiatrists also identified the potentially beneficial
nature of some aspects of Vietnamese society and culture being eroded by
modernization, including traditional family structures, forms of employment and
lifestyles. Conclusions: The perspectives of psychiatrists in this study suggest that
socioeconomic change may be exerting conflicting influences on the outcomes of
schizophrenia in Vietnam and other developing countries. Their views have
implications in terms of how adequate treatment and support for people with
severe mental illness can be provided in the context of limited resources, staffing
and formal treatment options. Further research is needed to establish current
recovery rates and prospectively explore the impact of modernization on
outcomes.
2.Haemophilus influenzae type B conjugate vaccine (HiBCV) and heptavalent pneumococcal conjugate vaccine (PCV7) immunization status of patients 5 years and below hospitalized for pneumonia
Lou Ver Leigh A. Manzon ; Robert Dennis J. Garcia ; Sally Victoria B. King
Pediatric Infectious Disease Society of the Philippines Journal 2012;13(2):30-36
Introduction: Community-acquired pneumonia remains to be an important cause of morbidity and mortality among the pediatric age group with Streptococcus pneumoniae and Haemophilus influenzae typ B being the predominant bacteria identified. Conjugate vaccines against these organisms are available however, the prevalence of pneumonia in our country continues to be high.
Objectives: The aim of this research is to determine the HiBCV and PCV 7 immunization status of children 5 years and below who were hospitalized due to pneumonia compared to controls. This study also aims to describe the clinical outcome of pneumonia among children who were vaccinated with HiBCV and/or PCV7 compared to those without vaccination.
Methods: This retrospective case-control study was conducted in Makati Medical Center from January 1, 2009 to August 31, 2010. Cases were children five years old and below discharged with the final diagnosis of pneumonia. Controls were patients five years and below discharged without pneumonia during the same study period. Medical records were reviewed for information on age, gender, clinical findings upon admission, laboratory results, vaccination status, interventions and outcomes.
Conclusion: The findings indicated that clinical and radiologically-confirmed pneumonia still occurred among children with complete vaccination with HiBCV and PCV7. Although not statistically significant, those without vaccination had higher odds of having pneumonia.
Human
;
Male
;
Female
;
Child Preschool
;
Infant
;
HAEMOPHILUS INFLUENZAE TYPE B
;
VACCINES, CONJUGATE
;
HEPTAVALENT PNEUMOCOCCAL CONJUGATE VACCINE
;
IMMUNIZATION
;
PNEUMONIA
3.Use of an Optical Scanning Device to Monitor the Progress of Noninvasive Treatments for Chest Wall Deformity: A Pilot Study.
Robert E KELLY ; Robert J OBERMEYER ; M Ann KUHN ; Frazier W FRANTZ ; Mohammad F OBEID ; Nahom KIDANE ; Frederic D MCKENZIE
The Korean Journal of Thoracic and Cardiovascular Surgery 2018;51(6):390-394
BACKGROUND: The nonsurgical treatment of chest wall deformity by a vacuum bell or external brace is gradual, with correction taking place over months. Monitoring the progress of nonsurgical treatment of chest wall deformity has relied on the ancient methods of measuring the depth of the excavatum and the protrusion of the carinatum. Patients, who are often adolescent, may become discouraged and abandon treatment. METHODS: Optical scanning was utilized before and after the intervention to assess the effectiveness of treatment. The device measured the change in chest shape at each visit. In this pilot study, patients were included if they were willing to undergo scanning before and after treatment. Both surgical and nonsurgical treatment results were assessed. RESULTS: Scanning was successful in 7 patients. Optical scanning allowed a visually clear, precise assessment of treatment, whether by operation, vacuum bell (for pectus excavatum), or external compression brace (for pectus carinatum). Millimeter-scale differences were identified and presented graphically to patients and families. CONCLUSION: Optical scanning with the digital subtraction of images obtained months apart allows a comparison of chest shape before and after treatment. For nonsurgical, gradual methods, this allows the patient to more easily appreciate progress. We speculate that this will increase adherence to these methods in adolescent patients.
Adolescent
;
Braces
;
Congenital Abnormalities*
;
Funnel Chest
;
Humans
;
Pectus Carinatum
;
Pilot Projects*
;
Thoracic Wall*
;
Thorax*
;
Vacuum
4.Influence of lateralized versus medialized reverse shoulder arthroplasty design on external and internal rotation: a systematic review and meta-analysis
Kevin A. HAO ; Robert J. CUETO ; Christel GHARBY ; David FREEMAN ; Joseph J. KING ; Thomas W. WRIGHT ; Diana ALMADER-DOUGLAS ; Bradley S. SCHOCH ; Jean-David WERTHEL
Clinics in Shoulder and Elbow 2024;27(1):59-71
Restoration of external (ER) and internal rotation (IR) after Grammont-style reverse shoulder arthroplasty (RSA) is often unreliable. The purpose of this systematic review was to evaluate the influence of RSA medio-lateral offset and subscapularis repair on axial rotation after RSA. Methods: We conducted a systematic review of studies evaluating axial rotation (ER, IR, or both) after RSA with a defined implant design. Medio-lateral implant classification was adopted from Werthel et al. Meta-analysis was conducted using a random-effects model. Results: Thirty-two studies reporting 2,233 RSAs were included (mean patient age, 72.5 years; follow-up, 43 months; 64% female). The subscapularis was repaired in 91% (n=2,032) of shoulders and did not differ based on global implant lateralization (91% for both, P=0.602). On meta-analysis, globally lateralized implants achieved greater postoperative ER (40° [36°–44°] vs. 27° [22°–32°], P<0.001) and postoperative improvement in ER (20° [15°–26°] vs. 10° [5°–15°], P<0.001). Lateralized implants with subscapularis repair or medialized implants without subscapularis repair had significantly greater postoperative ER and postoperative improvement in ER compared to globally medialized implants with subscapularis repair (P<0.001 for both). Mean postoperative IR was reported in 56% (n=18) of studies and achieved the minimum necessary IR in 51% of lateralized (n=325, 5 cohorts) versus 36% (n=177, 5 cohorts) of medialized implants. Conclusions: Lateralized RSA produces superior axial rotation compared to medialized RSA. Lateralized RSA with subscapularis repair and medialized RSA without subscapularis repair provide greater axial rotation compared to medialized RSA with subscapularis repair. Level of evidence: 2A.
5.An ultrasound-guided fascia iliaca catheter technique does not impair ambulatory ability within a clinical pathway for total hip arthroplasty.
Seshadri C MUDUMBAI ; T Edward KIM ; Steven K HOWARD ; Nicholas J GIORI ; Steven WOOLSON ; Toni GANAWAY ; Alex KOU ; Robert KING ; Edward R MARIANO
Korean Journal of Anesthesiology 2016;69(4):368-375
BACKGROUND: Both neuraxial and peripheral regional analgesic techniques offer postoperative analgesia for total hip arthroplasty (THA) patients. While no single technique is preferred, quadriceps muscle weakness from peripheral nerve blocks may impede rehabilitation. We designed this study to compare postoperative ambulation outcome in THA patients who were treated with a new ultrasound-guided fascia iliaca catheter (FIC) technique or intrathecal morphine (ITM). METHODS: We reviewed the electronic health records of a sequential series of primary unilateral THA patients who were part of a standardized clinical pathway; apart from differences in regional analgesic technique, all other aspects of the pathway were the same. Our primary outcome was total ambulation distance (meters) combined for postoperative days 1 and 2. Secondary outcomes included daily opioid consumption (morphine milligram equivalents) and analgesic-related side effects. We examined the association between the primary outcome and analgesic technique by performing crude and adjusted ordinary least-squares linear regression. A P value < 0.05 was considered statistically-significant. RESULTS: The study analyzed the records of 179 patients (fascia iliaca, n = 106; intrathecal, n = 73). The primary outcome (total ambulation distance) did not differ between the groups (P = 0.08). Body mass index (BMI) was the only factor (β = -1.7 [95% CI -0.5 to -2.9], P < 0.01) associated with ambulation distance. Opioid consumption did not differ, while increased pruritus was seen in the intrathecal group (P < 0.01). CONCLUSIONS: BMI affects postoperative ambulation outcome after hip arthroplasty, whereas the type of regional analgesic technique used does not. An ultrasound-guided FIC technique offers similar analgesia with fewer side effects when compared with ITM.
Analgesia
;
Anesthesia, Conduction
;
Anesthesia, Spinal
;
Arthroplasty
;
Arthroplasty, Replacement, Hip*
;
Body Mass Index
;
Catheters*
;
Critical Pathways*
;
Electronic Health Records
;
Fascia*
;
Hip
;
Humans
;
Linear Models
;
Morphine
;
Nerve Block
;
Peripheral Nerves
;
Pruritus
;
Quadriceps Muscle
;
Rehabilitation
;
Ultrasonography
;
Walking
6.An ultrasound-guided fascia iliaca catheter technique does not impair ambulatory ability within a clinical pathway for total hip arthroplasty
Seshadri C. MUDUMBAI ; T. Edward KIM ; Steven K. HOWARD ; Nicholas J. GIORI ; Steven WOOLSON ; Toni GANAWAY ; Alex KOU ; Robert KING ; Edward R. MARIANO
Korean Journal of Anesthesiology 2020;73(3):267-267