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Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
Formal neuropsychological testing usually involves a series of tests that assess specific aspects of brain function. This process often takes far longer (typically two to three hours) than practical for a medical assessment, plus the results can only accurately be interpreted by a specialist with comparison to data for standard populations. A reasonable intermediate step between the MMSE or MOCA and formal neuropsychology is the Addenbrooke's Cognitive Examination third version (ACE-III).20 This series of questions incorporates attention, memory and visuospatial tests along with more elaborate tests of a wider range of specific cognitive domains (including executive function) to give a score out of 100. The higher the score, the better the cognition, with a cut-off point below 87 suggesting significant impairment. Subtle deficits will only be detected with more complex testing. In late dementia, all areas of cognition will become impaired and the discriminatory ability to diagnose specific dementia syndromes will become diminished. Another option is the Free-Cog test that performs similarly to the MMSE, MOCA or ACE-III but is not subject to any copyright restrictions.21
Workers’ Compensation Case Evaluation
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
An independent medical examination (IME) is a medical examination performed by a physician or healthcare provider not involved in the care of the examinee, for the purpose of clarifying issues associated with the case (Benzon, 2014). There is no provider–patient relationship, and none should develop. The examiner or evaluator should be impartial, unbiased, and objective. The evaluation includes the basics of a medical assessment, history, examination, and review of diagnostic studies.
Introduction
Published in Deb Thompson, Kim Wright, Developing a Unified Patient Record, 2018
Doctors write free text on blank continuation sheets within the case notes, which are generally stored in a trolley at the nurses’ station. The medical assessment process is systematic; medical assessment leads to the generation of a problem list, which is the basis of any treatment plans. The absence of a written framework means that the medical assessment record can lack consistency. Handwriting is often illegible. Doctors use shorthand for speed and often have separate sections in the case notes, dependent on specialty. This means that, although there is a chronological record, it is often inconsistent, hard to read and in several different places within the case notes. Ongoing patient assessment can be scanty, possibly due to lack of a consistent framework.
A Framework for EMS Outreach for Drug Overdose Survivors: A Case Report of the Houston Emergency Opioid Engagement System
Published in Prehospital Emergency Care, 2021
James R. Langabeer, David Persse, Andrea Yatsco, Meredith M. O’Neal, Tiffany Champagne-Langabeer
After the outreach is complete, the recovery coach submits the patient forms from enrollment through outreach to the patient navigator. They are responsible for contacting patients to follow-up and schedule all clinical visits. The treatment model in our case involves a medical assessment by an advanced nurse practitioner and a telehealth consultation with an emergency physician. Currently our emergency physician provides the patient with a one or two-week prescription for buprenorphine/naloxone (Suboxone®) as an interim treatment until the patient is connected with a longer term program that will manage ongoing MOUD. We also provide regular support group meetings and individual behavioral counseling. Occasionally, patients enrolled through outreach will not follow-up. If this is the case, the patient navigator will attempt to reestablish contact with patient, or they will be added into the following week’s outreach list for follow-up.
Participation seven years after severe childhood traumatic brain injury*
Published in Disability and Rehabilitation, 2020
Hugo Câmara-Costa, Leila Francillette, Marion Opatowski, Hanna Toure, Dominique Brugel, Anne Laurent-Vannier, Philippe Meyer, Georges Dellatolas, Laurence Watier, Mathilde Chevignard
This study was approved by the (Comité de Protection de Personnes d’Île-de-France VI [CPP IDF VI]) ethics committee and parents gave their informed written consent to participate in the study. Patients (parents for those under 18 years of age) who had been included in the TGE study were contacted by the treating physician assessing them in the initial phase of the study and asked to participate in the 7-year follow-up. The assessments took place in the Rehabilitation Department in the Saint Maurice Hospitals, on two separate occasions. A physician specialized in Physical Medicine and Rehabilitation performed the medical assessment, which included information about ongoing medications, care and rehabilitation therapies, type of ongoing education and current occupation, GOS-E or GOS-E Peds rating scales, and a neurological examination assessing the presence of motor, visual or hearing impairments. In a different day, a trained child psychologist performed the neuropsychological assessment, and administered the self-version questionnaires in a fixed order, while parents answered the proxy-versions of the questionnaires. For the control group, the data collected during this period was the same as for the TBI group, although controls did not undergo the medical examination and only performed a reduced number of the neuropsychological assessments administered to patients.
The use of bacterial DNA from saliva for the detection of GAS pharyngitis
Published in Journal of Oral Microbiology, 2020
Saar Hashavya, Naama Pines, Ayelet Gayego, Avi Schechter, Itai Gross, Alon Moses
A total of 102 subjects were enrolled. One subject dropped out of the study, and another subject was excluded due to loss of the saliva sample. A total of 100 subjects underwent analysis. The overall prevalence of GAS was 55% and 48% as determined by the throat culture and saliva PCR, respectively. The average age (±SD) of the patients was 8.4 years (±2.6); 51% were females. Twenty- five percent of the subjects had GAS pharyngitis in the previous six months and 17% had an additional family member with GAS pharyngitis. Of the children who had a GAS infection in the 6 months prior to the study, 58% had a positive culture. Seventy- two percent of the subjects had fever, 45% had exudates and 20% lymphadenopathy. Of the patients with a positive culture, 51% had exudates, 78% had fever and 18% had enlarged cervical lymph nodes. The average length of illness prior to medical assessment was 1.4 days (±0.7).