Abstract This paper discusses indications and contraindications for liver transplantation. It discusses the MELD and PELD scoring systems and explains how they prioritize patients for receipt of a transplant. It also examines recent developments that now enable previously unsuitable candidates to be considered for transplantation.
From the Paper "Transplantation is the accepted treatment for patients with end stage liver disease. Because of an increasing number of patients being referred for transplantation, the gap between donate livers and recipients on the waiting list is ever increasing..."
Abstract This paper takes a look at cirrhosis, or liverdisease, the causes of the disease and the effects that the disease has on the human body. This paper also takes a look at the possible complications caused by cirrhosis, as well as the various available treatments.
Outline:
Cirrhosis
Causes
Signs and Symptoms
Complications
Diagnosis and Imaging Modalities
Treatment
Conclusions
Diagrams of the Liver
From the Paper "Both genetic and lifestyle factors can cause alcoholic cirrhosis. About 50% of the cases of cirrhosis belong to this condition. Liver's capacity can be overworked by chemical and drug overload leading to scarring. A possible cause is any illness that injures the liver like viral hepatitis B and C and chronic active hepatitis and autoimmune hepatitis. A secondary condition to a very old bile duct obstruction and jaundice is an autoimmune condition described as biliary cirrhosis or cirrhosis. A condition called Sarcoidosis that looks like tuberculosis can cause cirrhosis. This is presently considered an autoimmune disease. One more cause is heart failure causing blood to pool in the liver and this overcrowding can cause cirrhosis. (Cirrhosis: www.gutdoc.org)"
Abstract This paper explains that the numerous factors of kidney disease can directly affect a sufferer's state of mind. Not only is there physical pain involved, but also there is the humiliation of having a catheter, the burden of dialysis, the stress of the potential of transplant surgery and the possibility of putting a loved one in danger if they become a donor. The author points out that diagnosis and appropriate treatment of a psychiatric problem related to chronic kidney disease depends on a rational assessment of numerous contributing factors and the strengths and weaknesses of the individual. The paper stresses that one of the most important roles the advanced practice nurse is early detection and intervention.
Table of Contents:
Introduction
Overview of Kidney Disease Implications for Mental Health
Diagnosis and Treatment
Role of the Advanced Practice Nurse
From the Paper "Statistically, men and women over 55 face an increasing probability of acquiring some chronic disease (Birren & Sloane, 2001). A psychiatric symptom such as poor memory may be related to organic illness, for example, a brain disorder, or represent a psychological aspect of an illness, for example, depression. Depression is the most frequent incapacitating psychiatric problem throughout life. More than half the victims of a serious depression have their first episode after 60, and estimates are that careful clinical examination would confirm depression in 10 to 30 percent of those over 65."
Abstract This paper takes a look at liverdisease, the liver transplant operation, patients awaiting liver transplants and post transplant patients. This paper specifically focuses on the surgical intensive care unit Mayo Clinic at St. Luke's Hospital, Jacksonville USA, and studies a patient referred to as F.M, a 58 year old white male from Boston, MA.
From the Paper "F.M. had a history of ETOH abuse. It is reported that he had a history of 42 beers/wk for thirty years. This amounts to a six pack a day for thirty years. F.M. reports quitting in March of 2003. Alcohol can induce alcoholic cirrhosis. Alcohol is converted to acetaldehyde that causes the alteration of hepatocyte function. It impairs mitochondrial function that decreases oxidation of fatty acid. Enzyme and protein synthesis is altered leading to diminished degradation of hormones and ammonia. When inhibition of export of protein from the liver occurs alteration in metabolism of vitamins and minerals induce malnutrition. The alteration of hepatocyte function is what ultimately triggers the cellular damage to the liver which initiates the inflammatory response. The damage caused from this process is slowly progressive and thought to be reversible depending on extent of damage (Dirksen, Heitkemper, & Lewis 2004).
The major risk factor that F.M. has contributing to his current condition is Hepatitis C Virus (HCV). HCV is an RNA virus that is mainly transmitted percutaneously. This virus causes direct cellular damage to the liver initiating the inflammatory response. The course of this virus varies with extensive damage not showing up until 25-30 years later. A reliable antibody test was not widely available before 1992. So many patients given blood or blood products before then are at risk for infection (Dirksen, Heitkemper, & Lewis 2004). F.M was a veteran of the Vietnam War in the 1960s and received a blood transfusion at that time. "
Abstract This paper presents a study on understanding the adolescent experiences in relation to Gaucher's Disease. The hypotheses for the study are "Adolescents with Gaucher's Disease have a different perspective of the self than adolescents not diagnosed with a chronic illness" and "Adolescents with Gaucher's Disease perceive friendships and social interactions differently than adolescents who do not have a chronic illness". In relation to the hypotheses, the study concentrates more on understanding how identity or self in adolescence is being affected by the Gaucher's Disease.
From the Paper "People think of themselves as optimists or pessimists, and this is a reflection of our personality traits in opposites. The questions of being emotional or unemotional, dependent or independent, aggressive or passive, leader or follower, adventurous or cautious are also marks of these opposing traits. Most of these are natural inborn temperaments, but some of the characteristics of man like the feelings of competence or inferiority, and appearances as learned are based on the support and challenges faced by us during growing up. Erik Erickson explored this concept thoroughly. Though he had a great influence of Freud, the existence of ego from birth, and that behavior not being totally defensive were also his beliefs. He studied Sioux Indians on a reservation, and this made him aware of the great influence of culture on behavior. This made him place a lot of stress on the external world, like war and depression."
Abstract This paper examines the criteria used to determine who may receive a liver transplant and, in particular, whether alcoholics should be allotted livers for transplant. Alcoholics tend to be given low priority status on liver transplant waiting lists or are even taken off such lists because they are considered responsible for their organ's diseased condition. The paper questions whether the denial of transplants based on this moral criteria is justified. It concludes by arguing that alcoholics should be given the same priority level as non-alcoholics on the same transplant waiting lists.
From the Paper "Deciding who should receive organs is not based solely on medical need, but also on moral criteria. Initially, patients must display a genuine medical need for a new organ, meaning that they will indeed die unless they receive a transplant. Then they are eligible to be placed on a waiting list. Patients on the list are then chosen one-by-one as organs become available (Kilner 5). However, it is most certainly always the case that the available organ could potentially be given to more than one person on the list. In this situation, a single recipient must be chosen. A team of physicians and a psychologist determine which patient will be given a new chance at life through the transplantation of a new organ ... but how exactly do they decide?"
Abstract This paper discusses chronic respiratory disorders. The paper examines issues concerning the management of these diseases. The economic benefits for corporations and managed health care are explored. The paper contends that studies have shown time and again that a healthier workforce is a more productive workforce and companies that invest in efficient healthcare plans for their employees generally receive a large return on their investment, notwithstanding the humanitarian implications involved.
Outline
Executive Summary
Background and Overview
Managed Health Care
Incidence of Chronic Respiratory Diseases in the United States
Discussion
Potential Cost Savings from Managed Care Approach
Constraints and Considerations
Conclusions and Recommendations
From the Paper "Gatekeeping strategies provided under managed care programs typically include requiring preapproval for services or screening by a primary care physician prior to referral for tests or a specialist visit. In addition, gatekeeping directs patients to certain providers, usually those who have contracted to follow the company's policies and have accepted discounted payments in return for a steady flow of referrals. As the term implies, the gatekeeping function introduces issues that those who need services may be denied them, for instance, based on a strict interpretation of the criteria of "medical necessity." Another constraint is that understaffing or a lack of appropriate credentials among gatekeepers will result in delays in the provision of healthcare assistance or even to adverse decisions about employee healthcare. "Finally, the question of providers' loyalty is raised by the contractual arrangement," Strom-Gottfried ask, "can they fulfill the fiduciary responsibility to their patients while under the management of the payor?" (297)."
Abstract This paper defined disease as anything impairing the normal state or functioning of the body as a whole or of any of its parts, explaining how certain diseases are short lived, but severe, others chronic. The author classifies diseases by their cause and how infectious they may be.
From the paper:
"Disease can be defined as anything impairing the normal state or functioning of the body as a whole or of any of its parts. Some diseases are short lived, but they are accompanied by severe symptoms. Others are chronic, or diseases that last a long time. Diseases are classified by their cause; this could be a virus, bacteria, rickettsias, or protozoa. Fungi and parasitic worms can also cause diseases. Human, certain animals and insects, and infected objects can transmit only infectious diseases. Chemical and physical agents such as drugs, poisons, and radiation can also cause disease."
Abstract This research paper looks at how knowledge of the behavioral and emotional responses of patients with chronic illness are an important part of their treatment, remission, and/or acceptance of their illness. The paper points out that physicians often look only at the physical aspects of the disease and therefore do not do enough to study and help the emotional and behavioral issues that may also come along with chronic illnesses. Consequently, the problem of a lack of emotional and behavioral support within the medical system is something that must be addressed. This paper attempts to look at this issue from the perspective of the patient and to work toward finding an outcome that is beneficial to all that are involved.
Background
Statement of the Problem
Purpose of the Study
Importance of the Study
Scope of the Study
Overview of the Study
Review of Related Literature
Methodology
Analysis of the Data
Summary, Recommendations and Conclusions
From the Paper "In many instances the medical profession focuses mainly on the physical manifestations of chronic illness and aggressive treatment plans without consideration of the cumulative effects the treatments, medication, physical pain, or surgical procedures have on the individual's psychological, emotional, and behavioral well-being. The emotional, behavioral, and physical manifestations of the illness directly affect the patient's ability to cope, the quality of life, and the manner in which the illness affects family and social relationships. "
Abstract This paper examines chronic fatigue syndrome (CFS) its diagnosis, and the ways in which healthcare providers are learning to better manage its symptoms. The paper gives a brief history of the disease, citing when it was first noted as a condition. Today's definition of CFS is also given. The author then suggests various causes of the condition, although there are no definitive answers. The various treatment options are presented, although this is also controversial. The paper includes a review of several recent studies on CFS. The author concludes that CFS will continue to present challenges to both healthcare providers and sufferers since the disease is one example of the large range of medically unexplained syndromes today.
From the Paper "Today, CDC defines the illness as: "a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity." Individuals having CFS most often function at a substantially lower level of activity than capable of prior to the illness. In addition to these key defining characteristics, patients also report a number of nonspecific symptoms, such as weakness, muscle pain, impaired memory and/or mental concentration, insomnia, and post-exertional fatigue lasting more than 24 hours. Mental health professionals also recognize that CFS often relates to depression. In some cases, CFS can persist for years (CDC, 2006). "
Abstract This paper discusses the need for learning when dealing with a chronic illness, such as rheumatoid arthritis. The paper discusses the signs and symptoms of arthritis and then, more specifically, of rheumatoid arthritis. The paper discusses how a patient can better cope with a chronic illness if they are familiar with it.
From the Paper "Analysis of Storytelling Living with a chronic illness such as rheumatoid arthritis requires learning. Arthritis is a progressive disease; strategies for living with chronic disease must change as the disease progresses (Charmaz, 1991). Rheumatoid arthritis is a condition that "involves inflammation of the lining of the joints and tendon sheaths of the body and thickening of the synovium and joint swelling" (Ryan & Oliver, 2002, p. 45)."
Abstract This paper reviews a mid-range theory in a peer reviewed nursing article. The paper explores the mid-range theory of chronic sorrow as it is discussed in LaDonna Northington's article 'Chronic Sorrow in Caregivers of School Age Children with Sickle Cell Disease: A Grounded Theory Approach.' The paper then explains why this article was chosen, provide an overview of the theory, discuss some key points which cannot be passed over in silence, analyze how the theory is utilized by the academic in question, and consider the article's (and the theories) general strengths and weaknesses.
Abstract The paper discusses lupus, a group of diseases, the most common and serious being systemic lupus erythematosus (SLE). The paper discusses the history of SLE and relates that lupus can affect men, women and children of any age, but has shown to mostly affect women of childbearing age, 15 to 45. The paper notes the signs of lupus and the standard treatments involved.
From the Paper "The history of SLE can be traced to three periods, namely, the classical, neoclassical and modern (Wikipedia 2006). In the classical period, the disease was first recognized in the Middle Ages, basically through its dermatological manifestations. The term "lupus" was first used in the 12th century by the physician Rogerius in describing the classic malar rash on the skin. In the neoclassical period, Moritz Kaposi first recognized the systemic manifestation of lupus in 1872. And in the modern period, which began in 1948, the LE cell was discovered."
Abstract The writer discusses the coping abilities, beliefs and relationships of clients dealing with chronic renal disease as well as her personal beliefs about family, health and hope. The writer focuses on a case study of a client with renal disease undergoing hemodialysis and shows how patients face a lot of challenges in their lives, notwithstanding the physiological and psychological stress of this condition. The writer also offers several personal reflections regarding the experience.
Outline:
Introduction
Patient Case
Conclusion
From the Paper "Currently, her problems during dialysis include leg cramping, for which hypertonic saline and locally applied pressure were given and done, respectively with relief of cramping. She also complained of easy fatigability of her left forearm and hand, especially when doing repetitive tasks, which was also the arm used for hemodialysis vascular access. This was also associated with blanching of her fingers. Other problems include being underweight, for which IDPN at each dialysis session was given. She was also advised by her physician of the need for a sufficient calorie reserve due to her increased risk for systemic infection and fractures, the former exemplified by a recent bout of pneumonia. "
Abstract The paper discusses the onset of coronary artery disease and the condition of atherosclerosis. The paper explains that coronary artery disease is primarily characterized as an inflammation of the arteries. The paper outlines the causes of this inflammation and examines the strong correlation between coronary artery disease and chronic obstructive pulmonary disease (COPD) as well as with Type II Diabetes. The paper looks at the most serious complication from coronary artery disease, which is the possibility of a heart attack.
From the Paper "Coronary artery disease (CAD) is a frightening name for an all-too common illness. It is the most common type of heart disease and the leading cause of death in the United States for both men and women ("What Is Coronary Artery Disease?" NIH, 2007). More than 64 million Americans suffer from some form of cardiovascular disease, and in 2001, cardiovascular disease was responsible for more than 39 percent of all deaths in the United States (American Heart Association: Heart Disease and Stroke Statistics 2004, cited by "Coronary Artery Disease and Atherosclerosis, Health Concerns, 2006, p1)."
