1/4. Aplasia of the right lung in a 4-year-old child: surgical stabilization of the mediastinum by diaphragm translocation leading to complete recovery from respiratory distress syndrome.lung aplasia is defined as unilateral absence of the lung with preservation of main bronchus remnant at the tracheal bifurcation. patients usually die soon after birth and there is no specific therapy for this condition, as evidenced by the literature. The authors present a case of an infant that was asymptomatic with this malformation until 3 months of age, when the child had respiratory distress syndrome. Subsequently, lung aplasia was diagnosed. The authors performed an extrapleural dissection and cephalad translocation of diaphragm to reduce the mediastinal shift and heart rotation, to relieve a kink and compression of the trachea by the aortal arch and truncus arteriosus, as well as to relieve hyperinflation of lung parenchyma and provide recovery from respiratory distress syndrome. This new approach resulted in complete recovery from respiratory distress syndrome and full tolerance of physical exercise. The child underwent follow-up for 4 years. Diaphragmatic translocation may be useful in treatment of respiratory disorders associated with lung aplasia.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. The process of recovery: a tale of two men.Recovery has been identified as a focus for mental health care. Recovery requires learning to live again after a life-altering acute event or during a chronic illness, mental or physical. By analyzing within-person change over time, utilizing multiple sources of evidence, two cases illustrated particular dimensions that influenced the recovery process after stroke, within a biopsychosocial framework. Restoration of the self, through co-occurring, dual processes of grief and reconstruction, appeared to be an essential dimension in the recovery process. Suggestions for integrating this concept into current adult clinical practice are congruent with current models of disease management of several chronic conditions.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/4. Nursing interventions within the Mauk Model of Poststroke Recovery.stroke continues to be the third leading cause of death in the united states. According to the National stroke Association (NSA, 2004) and the american heart association (AHA, 2004), there are over 750,000 new or recurrent strokes per year, with many resulting in residual disability. stroke survivors often deal with the physical, psychosocial, and emotional consequences of stroke long after they have left the safety of professional rehabilitation. Patient instruction from nurses prior to discharge, while necessary, may be done at a point in the recovery process when the stroke survivor is not ready to learn how to deal with such consequences. Using the Mauk Model for Poststroke Recovery, nurses can identify which phase of recovery a survivor is in, and thus tailor care to his or her needs. The purpose of this article is to use the Mauk Model for Poststroke Recovery to present nursing interventions that are appropriate to each of the previously identified six phases of stroke recovery.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. Denial and rehabilitation of the post-infarction patient.The use of denial has been widely accepted as an adaptive and protective coping mechanism in the acute phase of myocardial infarction. Although instrumental in lowering anxiety and mortality in the acute phase of coronary care, the use of denial creates hazards for the patient in convalescence. These hazards, not well known to intensive care personnel but all too apparent to the liaison psychiatrist working in cardiovascular rehabilitation, include a high vulnerability to disruptive anxiety and even psychosis at times of transition from greater to lesser intensity nursing care and a maladaptive resistance to rehabilitation efforts in convalescence. Failure of denial under the stress of transition may produce a transient paranoid psychosis with a clear sensorium, a variant of Abram's "cardiac psychosis." maintenance of the defense in convalescence leads to noncompliance with medical advice and rejection of rehabilitation efforts, increasing the risk of reinfarction. A case report is presented illustrating both hazards. Recommendations for management include early recognition, supportive psychotherapy, education and mobilization in the acute phase of coronary care. Cardiovascular conditioning and reshaping of risk factors follow in convalescence. The physical and psychological benefits of this approach are reviewed. The adaptive value of denial in coronary patients is challenged from the long-term perspective of rehabilitation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |