Misdiagnosed Seizure-Like Activity in a Patient With Postural Orthostatic Tachycardia Syndrome: A Case Report.

Postural orthostatic tachycardia is a syndrome characterized by an elevated heart rate in response to standing. This syndrome typically presents in late adolescence and early adulthood, with a higher percentage occurring in females. This syndrome is often seen following a viral infection, pregnancy, surgery, or intense psychological stress. This condition presents a wide range of symptoms that vary depending on its unclear etiology. We present the case of a 21-year-old woman with convulsions associated with postural orthostatic tachycardia syndrome after being misdiagnosed with a psychiatric condition for many years.

The Awake Craniotomy: A Patient's Experience and A Literature Review.

We present a case report and a literature review of the awake craniotomy procedure for mass resection, with emphasis on the historical aspects, anatomical and surgical considerations, and, uniquely, a patient's experience undergoing this procedure. This procedure is a safe and effective method for lesion resection when working in and around eloquent brain. We have described our process of guiding a patient through an awake craniotomy procedure and detailed the patient's experience in this study. We also conducted a systematic literature review of studies involving awake craniotomy over three years, 2018-2021. Lastly, we compared the methodology used by our institution and the current mostly used methods within the neurosurgical community. Several studies were identified using PubMed and Google Scholar. Awake craniotomy is a safe and effective method of achieving a high rate of resection of lesions located in and around the eloquent cortex with a low degree of postoperative neurological deficit.

Introduction of Insulin Experiential Learning for Medical Students during Clinical Clerkship / 医学教育

In the treatment of diabetes, insulin therapy is becoming increasingly important. However, it is reported that insulin initiation is often delayed due to psychological resistance in patients and physician’s concerns about patient education. One of the reasons for this problem is medical doctors’ inadequate understanding of insulin self-injection and patients’ perspectives. Therefore, we introduced a new strategy for learning this more effectively. We set student doctors as target learners. The learning strategy consists of experiential learning through the use of insulin injection model, in-patient interviews, and small group learning. Our new practice seems to be useful to understand the perception gap between medical professionals and patients.

Patients' perceptions of orthodontic treatment experiences during COVID-19: a cross-sectional study.

BACKGROUND: COVID-19 has impacted the care of patients undergoing orthodontic treatment. We aimed to provide an overall view of patients' perspectives, concerns, and expectations towards their treatment throughout the clinic lockdown during the pandemic; and to assess patients' levels of mental distress and its association with their confidence in resuming care. METHODS: An anonymous, validated, in-person paper questionnaire was distributed to adult orthodontic patients' post-lockdown at an academic institution. The survey focused on the clinical aspects and patients' perspectives regarding orthodontic treatment during the pandemic. The Kessler Mental Distress Scale (K10) was used to evaluate their psychological status. Survey responses were descriptively summarized and confidence in resuming care was compared between normal patients and patients with mental distress using Mann-Whitney tests. RESULTS: One hundred fifty-four patients were surveyed from July to October 2020. Mean age of the participants was 29.30 (SD = 12.01) years and 62% were females. Emergencies during the closure (21%, 32/154) involved primarily irritation with protruding wires. Patients were neutral regarding tele-dentistry and preferred their current fixed appliances over clear aligners. Upon resuming care, 80.51% were extremely pleased with the restrictive protocols and with high level of confidence in resuming treatment. The average level of anxiety was low, and a modest association was found between mental distress and reduced confidence in resuming treatment. CONCLUSIONS: Few numbers of minor emergencies occurred during the clinic closure. Despite the rising interest in tele-dentistry, patients were neutral on considering this option to monitor treatment and were content with fixed appliances. Patients had high confidence levels to resume their care based on the protocols established upon reopening. The association of mental distress and confidence in resuming care is suggestive and needs further investigation.

Addressing the psychosocial needs of young people with thalassaemia undergoing bone marrow transplantation.

Beta thalassaemia major is an inherited condition that causes severe anaemia. Patients with the condition require regular blood transfusions. One curative treatment option available is bone marrow transplantation, but a bone marrow transplant is a high-risk, painful procedure requiring prolonged hospitalisation. Undergoing such a disruptive treatment can be a source of great anxiety for young people and their families, who will need honest, sensitive and empathetic communication, person-centred care, support to socialise and access education, involvement in decision-making and signposting to financial support. This article discusses the role of children's nurses in addressing the psychosocial needs of young people with thalassaemia who undergo bone marrow transplantation and in supporting young people's families.

A psychological investigation of coronavirus disease 2019 (COVID-19) patients in mobile cabin hospitals in Wuhan.

BACKGROUND: This study investigated the depression, anxiety, and insomnia levels of coronavirus disease 2019 (COVID-19) patients admitted to two mobile cabin hospitals in Jianghan District (Wuhan, China). METHODS: Thirty COVID-19 (eight mild type and twenty-two common type) patients were evaluated using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7 Questionnaire, the Insomnia Severity Index, and a semi-structured interview. RESULTS: All 30 patients reported varying degrees of anxiety, depression, and insomnia. The levels of depression and anxiety in mild type COVID-19 patients were significantly lower than those in common type COVID-19 patients. Significant improvements in depression (P<0.001) and anxiety (P<0.001) levels were found in the COVID-19 patients at the second evaluation compared with the baseline (admittance to hospital). More than 80% patients agreed that medical security, support from other patients, and a better living environment were the main reasons for improvements to their adverse psychological states. CONCLUSIONS: Varying degrees of anxiety, depression, and insomnia frequently occur in patients with COVID-19. Standard treatment protocols and patient-centered care in the mobile cabin hospitals in this study provided the chance for COVID-19 patients to successfully improve their mental health during the outbreak of the pandemic.

Trauma-informed care for people presenting to the emergency department with mental health issues.

There is a high prevalence of exposure to traumatic events in childhood among people who have mental health issues. Presentation to the emergency department (ED) can be challenging for these patients because the environment and their experience of care can trigger traumatic memories. Trauma-informed care is an approach to practice that is guided by knowledge of how trauma affects people's lives and their healthcare needs. Despite the increasing prevalence of mental health care delivery in EDs, the level of translation of trauma-informed care into nursing practice in this setting is largely unknown. Therefore, the authors undertook a narrative literature review, the aim of which was to gather evidence relevant to trauma-informed care in the ED and provide guidance on this practice for emergency nurses. Several databases were searched, and the relevant articles found were thematically analysed. Three emergent themes were identified from the literature: an access point for mental health care; staff attitudes; and the ED experience. Emergency nurses need to be aware of the effects of childhood trauma on people presenting with mental health issues and plan their approach to care to avoid potentially re-traumatising patients.

Impact of COVID-19 Lockdown on Patients Undergoing Orthodontic Treatment: A Questionnaire Study.

With COVID-19 declared as a worldwide pandemic, a nationwide lockdown was implemented overnight in India on March 24, 2020. With no prior warning or anticipation, patient appointments were temporarily ceased as institutions and clinics were indefinitely closed. To our knowledge, no study addresses the orthodontic patient perspective in such testing times, where they are entirely restricted to the confines of their homes. AIM: To assess the impact of the COVID-19-related lockdown on the treatment and psychology of patients undergoing orthodontic treatment. MATERIAL AND METHODS: A self-designed online exploratory questionnaire of 15 questions was distributed to 500 potential responders selected from obtained lists through messages and emails. It was mandatory to answer all questions and the survey was anonymized and did not contain any identifying information. Online consent was taken before participation in the study. The obtained data were evaluated using descriptive and inferential statistics. RESULTS: The response rate was 81.6%. The study revealed that the majority of patients were affected by the lack of access to orthodontic visits. The reasons for the same were attributed to fear of increased treatment duration, inconveniences caused by poking wires, broken brackets, etc., and lack of communication between the orthodontists and patients, among the various other reasons. The importance of orthodontic appointments was also understood by patients. CONCLUSION: The study threw light on the essential need for understanding the psychology of patients undergoing orthodontic treatment. In any situation where patients do not have access to seek help, all the factors discussed in the study should be considered and it is of utmost importance that orthodontic professionals see to it that their patients are being looked after mentally, if not physically, in whatever way possible.

Novas abordagens da atuação do psicólogo no contexto hospitalar / New approaches to the role of psychologists in hospitals

Este trabalho tem como objetivo fundamentar a psicologia hospitalar através de um breve histórico da inserção do psicólogo no hospital, suas principais funções e roteiro de avaliação interventiva, além de contribuir com um relato de experiência de um estágio realizado no Centro de Tratamento Oncológico - CTO da Santa Casa de Misericórdia de Araçatuba - SP. E por meio deste, explorar atendimentos no leito, sala de espera, priorizando a humanização, a fim de possibilitar ao paciente a ressignificação de algo que ele não pode alterar, a facticidade de estar acometido por um câncer, ajudando-o a assumir a sua condição existencial, a perceber suas responsabilidades nas escolhas efetuadas durante o tratamento(AU)

This work has how I aim to substantiate of the nosocomial psychology through soon historically of the insertion of the psychologist in the hospital, his principal functions and itinerary of evaluation intervention. Besides contributing with a report of experience through a traineeship carried out in the Centre of Treatment Oncológico - CTO of the Saint Marries of Compassion of Araçatuba - SP. And through this, to explore services in the bed, waiting room, to emphasize the humanization, in order to make possible to a patient the to give another sense of something what he cannot alter, the facticidade of being attacked by a cancer, when his existential condition to assume it, to realizing his responsibilities in the choices effectuated during the treatment(AU)