The Permanente journal
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The Permanente journal · Jan 2013
Effects and linguistic analysis of written traumatic emotional disclosure in an eating-disordered population.
In previous studies, writing about traumatic life events produced positive physical and psychological outcomes in various populations. Specific linguistic trends, such as increasing insight and cognitive words, have paralleled health benefits. ⋯ Whereas the expected linguistic trends were evident in the disclosure group writings, no correlating health benefits could be found between the disclosure and control groups. Eating-disordered populations, often alexithymic, may have difficulty engaging with the disclosure task and could potentially benefit from guidance in processing traumatic events and their affective states.
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The Permanente journal · Jan 2013
From the patient's perspective: is there a need to improve the quality of informed consent for surgery in training hospitals?
This study was performed to evaluate the presurgical informed consent process at a training hospital in Jamaica. ⋯ The current informed consent process in use in the surgical training program at the University Hospital of the West Indies requires improvement to meet expected ethical and legal standards.
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The Permanente journal · Jan 2013
Preoperative pain intensity and chronicity and postoperative analgesia markers of length of stay in patients undergoing spinal fusion.
Pain medication use is enormous in those looking for relief of chronic back pain. The impact of long-term analgesia use might serve as a marker for prolonged hospitalization due to undertreating postoperative pain, which could ultimately result in higher health care costs. ⋯ Postoperative pain management continues to be a challenge because of the need to balance satisfactory analgesia in patients with the fear of adverse effects due to overdosing. This challenge is even greater in patients with long-term narcotic use. Anecdotally, patients undergoing spinal fusion show an inverse relationship between LOS and amount of use of postoperative pain medication. A more extensive scientific review of current postoperative pain control protocols is warranted in patients undergoing spinal fusion.
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The Permanente journal · Jan 2013
Elimination of admission hypothermia in preterm very low-birth-weight infants by standardization of delivery room management.
Temperature instability is a serious but potentially preventable morbidity in preterm infants. Admission temperatures below 36°C are associated with increased mortality and late onset sepsis. ⋯ We reduced hypothermia in very low-birth-weight infants using a standardized protocol, multidisciplinary team approach, and continuous feedback. Sustaining improvement is a challenge that requires real-time progress evaluation of outcomes and ongoing staff education.
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The Permanente journal · Jan 2013
Case ReportsPropofol-related infusion syndrome: role of propofol in medical complications of sedated critical care patients.
Propofol is a popular anesthetic and sedative. Use of propofol has increased manifold in this country over the last decade, and it is most commonly used in intensive care settings. Its rapid action with short half-life, decreased cerebral oxygen consumption, and reduction of intracranial pressure are properties that have made it a favorite in the intensive care unit. Many of these patients are critically ill or injured and require prolonged sedation. Propofol has been associated with morbidity and mortality, and in such cases the question often arises regarding the role propofol plays in these complications. ⋯ It is hoped that this short report will bring more awareness of this entity so that it will be considered in the differential diagnosis in sedated critical care patients.