Articles: patients.
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During an 11-year period ending January 1, 1985, 352 patients had insertions of an intraaortic balloon pump (IABP) as an adjunct to medical or surgical therapy. Group I, 175 patients, could not be weaned from cardiopulmonary bypass and required intraaortic balloon pump (IABP). Thirty-nine patients (22%) died in the operating room. ⋯ Left ventricular dysfunction, myocardial infarction, and timely insertion of IABP are the primary determinants of survival. Approximately one-third of patients who required IABP will die. More involved techniques for mechanical support of the failing circulation, such as ventricular assist device or total artificial heart, may increase survival.
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A person who becomes demented can be considered as he presently is, a demented person, or in light of his entire life, of which dementia is but the final stage. These two perspectives can provide conflicting determinations of the person's interests and preferences, since what is best for a demented person at the time may not make his life better overall and may be directly contrary to preferences expressed while competent. Reflection on the concept of autonomy--what faculties it requires, what its point is--provides a clear understanding of the rights of the demented patient.
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Arch Phys Med Rehabil · Nov 1985
Comparative StudyChronic pain in spinal cord injury: comparison between inpatients and outpatients.
Chronic pain is a common clinical finding in spinal cord injury (SCI), with a reported incidence of between 45% and 90%. This figure was obtained by using nonstandardized pain evaluation and for mostly inpatient populations. Because of the shortcomings of previous investigations and the wide range of reported incidence, a study was conducted using self-rating pain measurement, an activity check list, and a drug-use rating scale. ⋯ Statistical analysis showed an incidence of chronic pain and decreased activity of 60% among inpatients and of 16.6% in outpatients. The drug-use rating scale was also significantly higher among inpatients while outpatients had a higher level of physical activity than inpatients. Whether these differences are causally related to the patient's hospitalization is difficult to determine.