Case management

An alternative method of managing patients with cerebellar infarction causing obstructive hydrocephalus is endoscopic third ventriculostomy. Baldauf et al. ° reviewed 10 cases managed by the use of endoscopic third ventriculostomy, 8 of whom had clinical improvement (measured as an improvement in the level of consciousness). This therapy is still experimental, and improvement in outcome has not been demonstrated. 

In most cases, management of intoxication is supportive. The most important goal is to maintain cardiopulmonary function. If consciousness is impaired, obtain blood chemistries and administer intravenous glucose and thiamine (100 to 250 mg). 

Case Management." Morbidity and Mortality Weekly Report 53 (RR-8) (2004). 

Centers for Disease Control and Prevention. "Medical Examiners, Coroners, and Biologic Terrorism A Guidebook for Surveillance and Case Management." Morbidity and Mortality Weekly Report 53 (No. RR-8) (2004). 

Advertising Promotional Labeling Staff William V. Purvis Division of Case Management Steven A. Masieiio Division of Inspection and Surveillance Joseph P. Salewski, Acting Division of Manufacturing and Product Quality John A. Elterman, Jr. 

In 1998 a Californian (MMWR, 2001) mother requested a blood lead level determination for her 18-month-old child. The result was a blood lead level (BLL) of 26 LLg/dl, which was well above the Center for Disease Control s (CDC) recommended criterion for clinical case management. It was subsequently found that the father had a BLL of 46 ( lg/dl, which was above the Occupational Safety and Health Administration (OSHA) requirement that workers with BLLs greater than 40 lg/dl receive additional medical examinations. Further testing found that his 4-month-old daughter had a BLL of 24 Rg/dl. This worker was employed in a company that refinished antique furniture, some of which was covered with lead-based paint. Subsequent testing of co-workers found that two refinishers had BLLs of 29 and 54 Rg/dl and four carpenters had BLLs of 46, 46, 47, and 56 ( lg/dl. A child in another family had a BLL of 16 ( lg/dl. What will be the long-term effects on the intellectual abilities of these children ... 

The same New Hampshire group have described continuous treatment teams (Drake et al. 1996), who treat the dual diagnosis patients, with 24-hour responsibility for case management. There is a flexible approach to individual and group therapy, the latter being either educational or treatment-oriented in the case of those committed to abstinence. There is a practical focus on social situation, social skills and aspects of daily living. 

Jerrell and Ridgeley (1995) compared three approaches - case management, behaviour therapy, and the 12-step model - at a follow-up of two years, and there was a suggestion, within generally encouraging results over 18 months, that behaviour therapy had the most effect, and 12-step treatment the least. In a number of studies expertly provided ultra-specialist treatment along the lines described has been found to be superior to... 

Schizophrenia was conceptualized as a behavior taught to a child by a schizophrenogenic parent. Patients were then isolated from their families for long-term hospital care. In recent years, the approach has been to effect social rehabilitation with active involvement of the family. We will first review evidence pertinent to earlier approaches and then discuss the more recent assertive case management model. 

Brown, S. (1987) Case Management Practice. An Examination of Casework in CMHTs, Interim Report to DHSS. 

Integrated Management of Childhood Diseases. An Initiative for Effective Case Management. 

For simple GHB ingestion in a spontaneously breathing patient, intubation (insertion of tube into the trachea) may not be necessary. In these cases, management may include positioning the body to reduce the risk of choking, oxygen supplementation, monitoring, stimulation, treatment for persistent bradycardia (abnormal slowness of the heart), and admission to the hospital for observation. 

Point of Care Services Wellness/Health Promotions Case Management... 

Kilbride H, Castor C, Hoffman E, Fuger KL. Thirty-six month outcome of prenatal cocaine exposure for term or near-term infants impact of early case management. J Dev Behav Pediatr 2000 21 19-26. 

Some policies may cover medications but not therapy, and other policies may do the opposite. In addition, patients may be willing to pay out of pocket for some services but not others. Limits or caps may be placed on medication charges or on the number of psychotherapy sessions allowed. Only certain types of providers may be covered by insurance, that is, only a psychiatrist or only certain types of situations, such as case management or crisis intervention only. Some services might require a primary care physician s referral, even when that physician knows very little about the patient or the problem. Finally, the deductible (the amount the patient must pay initially to obtain the service) can vary, depending on the insurance policy. 

Primary care case management (PCCM) is a form of managed care used in Medicaid. It is most common in sparsely populated areas where there are no HMOs available to contract with the state. PCCMs are physicians or groups with arrangements with physicians that contract with the state Medicaid agency to coordinate and monitor the use of primary care services by enrolled beneficiaries. PCCM contracts cover less than the full set of Medicaid benefits and typically involve minimal financial risk. 

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