Effectiveness of nursing intervention in short-term hospitalization for patients suffered from borderline personality disorder and self-harm. A narrative literature review

Introduction: Personality disorder sufferers with severe self-harm and experience long psychiatric hospitalizations have complex mental health conditions and are at risk of suicide. When the symptoms of emotional instability are combined with self-harm, the resulting crisis often becomes difficult for patients and caregivers to manage. To improve care during these crises, the Dutch Multidisciplinary Guideline for Personality Disorders designates “brief admission” (BA) hospitalizations as an ameliorative intervention. Objective: To describe the effectiveness of short hospitalization nursing care for people with borderline personality disorder and who practice self-harm, compared to ordinary hospitalization. Methods: A narrative review was conducted through the Embase and CINAHL databases, the selected articles had to answer the following research questions: “what are the observable benefits of short-term hospitalization on patients with borderline personality disorder?”; and “what are the benefits compared to short hospitalization operators?”. Results: Seven studies were selected. The results show that BA was perceived as an effective nursing intervention, which promoted the patient’s self-determination and self-care. This helped increase confidence in daily life and allowed people to maintain their daily routines, work, and relationships by decreasing long hospitalizations and increasing patient compliance. There has also been benefit from the staff, who report an improvement in work quality. Conclusions: This type of hospitalization has developed in Northern European states. BA has never been tested in the Italian healthcare sector. It would be appropriate and desirable, given the results obtained, to experiment with this procedure also in Italy to obtain specific feedback regarding the relationship of short-term hospitalization with our National Health Service. It is hoped that this research can be a stimulus in this sense

Clinical and ultrasonographic features of choroidal metastases based on primary cancer site: Long-term experience in a single center.

Introduction and purposeChoroidal metastases (CM) are the most common intraocular malignancies. With longer survival rates for cancer patients, CM will be increasingly encountered. We evaluated clinical and ultrasonographic (US) characteristics of CM in order to identify diagnostic biomarkers that correlate with the primary tumor site.MethodsThe medical records of all patients with CM evaluated at the Ocular Oncology Unit between February 2010 and March 2020 were analyzed.Results82 eyes of 70 patients were included. The primary cancer site was lung in 26 patients (37%), breast in 23 (33%), kidney in 9 (13%), gastrointestinal in 5 (7%), thyroid in 5 (7%), parathyroids and prostate respectively in 2 (3%). Fifty-five patients (78%) had other systemic metastases at the time of ocular diagnosis. Ten (14%) patients had no history of primary cancer. Bilateral CM were found in 20 patients (29%); fifty-six eyes (68%) had a single CM. The epicenter of CM was predominantly macula (43 eyes, 52%). The mean thickness was 4,1 mm (range 1,8-12,3). US structure was inhomogeneous in 67 eyes (82%). Reflectivity was mainly medium (39%) and medium-low (39%). In particular, CM from lung cancer showed lower reflectivity than those from the breast (p = 0,02). CM deriving from lung cancer were typically dome-shaped, whereas CM originating from breast were characteristically plateau shaped (p = 0,02). Seventy-four (91%) eyes presented fluid on optical coherence tomography.ConclusionWe significatively found that CM from lung cancer generally appear dome-shaped with medium-low internal reflectivity, whereas those from breast cancer typically present a plateau appearance and higher internal reflectivity. Though it is hard to identify the site of the primary tumor relying exclusively on clinical and US aspects, morphology and internal reflectivity can be considered as diagnostic biomarkers. Thus, the origin of the primary tumor can be suspected by integrating a constellation of findings

Brolucizumab For Wet Age-Related Macular Degeneration: One-Year Real-World Experience From A Tertiary Center

: Introduction To explore the early efficacy and safety of treatment with intravitreal injections of brolucizumab in patients presenting neovascular age-related macular degeneration (nAMD) in a real-world setting. Methods This retrospective study included 194 eyes of 180 patients with nAMD treated with standard 6-mg intravitreal injections (IVTs) of brolucizumab in our clinic between 11 March 2021 and 15 June 2022. Both treatment-naive (33 eyes) and switch-therapy patients (161 eyes) were included in the study. Best corrected visual acuity (BCVA), central subfield thickness (CST), retinal fluid distribution (classified as intraretinal, IRF; subretinal, SRF; under the pigmented epithelium, sRPEF), treatment intervals and adverse event rates were collected for analysis. Results Average follow-up time was 37.2±16.6 weeks. Mean baseline BCVA were 38.1±4.5 and 41.9±6.7 letters in the treatment-naive and switch-therapy groups, with a final gain of 16.0±4.9 (p<0.0001) and 10.7±5.9 (p<0.0001) letters in the two groups, respectively. Throughout the study period, CST significantly decreased in both treatment-naïve (from 352.0±129.4 to 284.2±93.8 µm; p=0.0015) and switch-therapy (from 369.9±140.5 to 307.4±123.5 µm; p<0.0001). Significant fluid control rates were achieved at the end of the study period (45% and 27% eyes were completely free-of-fluid in naïve and switch groups, respectively). Five eyes (2.6%) developed adverse events with different grades of intraocular inflammation (IOI) and visual outcomes. Conclusion Brolucizumab IVTs showed a very good anatomical and functional outcomes in both naive and switch patients in this real-world experience. Nevertheless, even showing a favorable risk/benefit profile, clinicians should be aware of the possibility of a small rate of complications