Résumé
PURPOSE: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. METHOD: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. RESULT: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. CONCLUSION: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.
Sujets)
Sujet âgé , Humains , Droits de l'homme , Maisons de repos , Soins , Contention physique , Contrôle social formelRésumé
Central pontine myelinolysis (CPM) is a neurologic disorder that is usually related to rapid correction of hyponatremia and chronic alcoholism. CPM involves concentrated, symmetric, noninflammatory demyelination within the central pons; this pathology also occurs in extrapontine regions. Frequently observed clinical manifestations are sudden weakness, dysphagia, dysarthria, loss of consciousness, and locked-in syndrome. We describe herein a case of CPM predominated by cerebellar signs without typical symptoms, but with involvement of the cerebellum or cerebellar peduncle.
Sujets)
Alcoolisme , Ataxie cérébelleuse , Cervelet , Troubles de la déglutition , Maladies démyélinisantes , Dysarthrie , Hyponatrémie , Myélinolyse centropontine , Maladies du système nerveux , Tétraplégie , Perte de conscienceRésumé
Dural carotid-cavernous fistula (CCF) is characterized by arteriovenous communications between the meningeal branches of the internal or external carotid arteries and the cavernous sinus. Although the triad of chemosis, proptosis, and ocular bruit has been regarded as a classic sign of CCF, dural CCF often lacks these features. Dural CCF is a rare cause of ophthalmoplegia, and so it may be overlooked when the classic symptoms are absent. We report herein a case of bilateral dural CCF that presented as unilateral isolated abducens nerve palsy.
Sujets)
Nerf abducens , Atteintes du nerf abducens , Artère carotide externe , Sinus caverneux , Grottes , Diplopie , Exophtalmie , Fistule , OphtalmoplégieRésumé
Cerebral venous sinus thrombosis (CVT) is a rare disease that's associated with a wide variety of clinical signs and symptoms, and CVT is a potentially lethal condition. Iron deficiency anemia (IDA) as the cause of an adult case of CVT is very rare. We report here on a patient with CVT with intracerebral hemorrhage that was caused by IDA, and the patient was treated with hemodilution. We suggest that hemodilution should be considered as another therapeutic option for CVT with cerebral hemorrhage in a patient suffering with IDA.
Sujets)
Adulte , Humains , Anémie par carence en fer , Hémorragie cérébrale , Hémodilution , Fer , Maladies rares , Thromboses des sinus intracrâniens , Stress psychologique , Thrombose veineuseRésumé
The idiopathic hypereosinophilic syndrome (IHES) is a heterogenous spectrum of disorders, characterized by a long lasting hypereosinophilia without identifiable underlying cause and by the presence of various end-organ dysfunction. The neurologic manifestations of IHES can be encephalopathy, organic psycho syndrome and polyneuropathy and in rare cases polymyositis. Central nervous system involvement is the second mostclinically important complication of the hypereosinophilic syndrome as it is associated with chronic disability and a poor prognosis. In this report, we describe two patients of IHES who presented anisolated third nerve palsy with pupillary involvement and were improved by corticosteroid therapy. They satisfied the criteria of IHES and the third cranial nerve was the only site of neurologic involvement. Early recognition of neurologic involvement in IHES and prompt treatment could lead to good outcome
Sujets)
Humains , Système nerveux central , Syndrome hyperéosinophilique , Manifestations neurologiques , Nerf oculomoteur , Atteintes du nerf moteur oculaire commun , Polymyosite , Polyneuropathies , PronosticRésumé
Congenital absence of nails usually occur as a rare isolated anomaly or combined with other ectodermal defects. This anomaly is regarded as an inherited disorder either dominantly or recessively but quite a few cases were reported as sporadically developed. The patient was a 2-month-old girl who had no nails on both her 2nd, 3rd toes but had rudimentary nails on her left big toe and both 4th toes at birth. We could not find any other congenital deformity, any family history of inherited diseases related to anonychia. Radiological findings revealed no visualization of both 4th distal phalanges, only. We report this case as congenital anonychia of a sporadic type which may have developed independently from an underlying bone abnormality. We also review other reported cases in the literature.
Sujets)
Femelle , Humains , Nourrisson , Malformations , Ectoderme , Hallux , Parturition , OrteilsRésumé
Blueberry muffin rashes occur in various diseases including TORCH syndrome, transfusion reactions, leukemia, hereditary spherocytosis and neonatal sepsis. We report a case of congenital CMV(cytomegalovirus) infection showing blueberry muffin skin lesions which revealed dermal erythropoiesis. Even though these cutaneous findings were nonspecific, they could provide a valuable clue in approach the congenital viral infection in the perinatal period.