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In-office Endonasal Minor Revision Rhinoplasty.

Facial Plast Surg 2021 Sep 20. Epub 2021 Sep 20.

Section of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.

The revision rhinoplasty presents many unique challenges to the facial plastic surgeon. While many cases will require a full revision in the operating room, there are several isolated deformities which may be repaired in the office via an endonasal approach. This provides many benefits to the patient and surgeon including decreased cost, shorter recovery time, avoidance of general anesthesia, and less discomfort. Read More

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September 2021

Effects of a simulation-based nursing process educational program: A mixed-methods study.

Nurse Educ Pract 2021 Sep 3;56:103188. Epub 2021 Sep 3.

Department of Nursing at Chang Gung University of Science and Technology, No. 261, Wenhua 1st Rd., Guishan District, Taoyuan 33303, Republic of China (Taiwan). Electronic address:

Aims: To examine the effects of a simulation-based nursing process educational program on nursing students' confidence in communication and foundational understanding of the nursing process.

Background: The nursing process is a core component of patient-centered nursing care that is underpinned by effective communication. However, learning how to engage patients and carry out the distinct steps of the nursing process can be challenging if students are not able to apply knowledge to practice. Read More

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September 2021

Real-world survey of pneumonitis and its impact on durvalumab consolidation therapy in patients with non-small cell lung cancer who received chemoradiotherapy after durvalumab approval (HOPE-005/CRIMSON).

Lung Cancer 2021 Sep 5;161:86-93. Epub 2021 Sep 5.

Department of Radiation Oncology, Kobe City Medical Center General Hospital, Hyogo, Japan.

Objectives: The incidence of real-world pneumonitis and durvalumab rechallenge during chemoradiotherapy and durvalumab consolidation for non-small cell lung cancer is unknown.

Materials And Methods: We retrospectively evaluated the medical records of 302 consecutive patients diagnosed with non-small cell lung cancer who started chemoradiotherapy between May 2018 and May 2019.

Results: Median age was 70 (range: 40-87) years. Read More

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September 2021

Experiences and needs of patients with rectal cancer confronted with bowel problems after stoma reversal: A systematic review and thematic-synthesis.

Eur J Oncol Nurs 2021 Aug 20;54:102018. Epub 2021 Aug 20.

Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff Member Nursing Department, Ghent University Hospital, Ghent, Belgium.

Purpose: After the reversal of the temporary stoma, rectal cancer survivors are often confronted with bowel complaints largely impacting on their quality of life. This systematic review aims to identify and synthesise the experiences and needs of patients with rectal cancer confronted with bowel problems after stoma reversal.

Methods: A systematic search was performed through Pubmed, CINAHL and Web of Science. Read More

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Community-based Lung Cancer Screening Results in Relation to Patient and Radiologist Characteristics: the PROSPR Consortium.

Ann Am Thorac Soc 2021 Sep 20. Epub 2021 Sep 20.

Kaiser Permanente Colorado, Institute for Health Research, Denver, United States.

Rationale: Lung-RADS classification was developed to standardize reporting and management of lung cancer screening using low-dose computed tomography (LDCT). While variation in Lung-RADS distribution between healthcare systems has been reported, it is unclear if this is explained by patient characteristics, radiologist experience with lung cancer screening, or other factors.

Objective: Our objective was to determine if patient or radiologist factors are associated with Lung-RADS score. Read More

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September 2021

Compounded Cerium Nitrate-Silver Sulfadiazine Cream is Safe and Effective for the Treatment of Burn Wounds: A Burn Center's Four-Year Experience.

J Burn Care Res 2021 Sep 20. Epub 2021 Sep 20.

Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA.

Wound infections and sepsis are significant causes of morbidity after burn injury and can be alleviated by early excision and grafting. In situations that preclude early surgery, topical agents allow for a safer delay. Cerium nitrate compounded with silver sulfadiazine (Ce-SSD) is a burn cream that provides broad antibacterial activity, forms a temporary barrier, and promotes re-epithelialization. Read More

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September 2021

Impact of Concussion History on Heart Rate Variability during Bouts of Acute Stress.

J Athl Train 2021 Sep 20. Epub 2021 Sep 20.

Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

Context: Following a sports-related concussion, many athletes experience persisting neurophysiological alterations. These alterations may be absent at rest but emerge during moments of physiological stress. Unnoticed and untreated neurophysiological dysfunction may negatively impact long-term neurological health in adolescent athletes as they are at a critical point in development. Read More

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September 2021

Noninvasive Expandable Endoprostheses From Reconstruction to Skeletal Maturity: A Surgical Technique and Lengthening Guide.

J Am Acad Orthop Surg 2021 Sep 17. Epub 2021 Sep 17.

From the Erlanger Orthopaedic Institute, University of Tennessee/Erlanger Orthopaedics (Voskuil), Division of Musculoskeletal Oncology, University of Tennessee College of Medicine-Chattanooga, Department of Orthopaedic Surgery (Voskuil), the Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga (Miles), and the Division of Musculoskeletal Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center and Nationwide Children's Hospital (Scharschmidt and Alexander).

Limb salvage is the benchmark for pediatric extremity bone sarcomas. However, reconstructive strategies must account for any anticipated remaining growth potential and the resultant limb inequality. Expandable endoprostheses offer the theoretical advantage of immediate weight-bearing, predictable function, and reliable maintenance of leg-length equality. Read More

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September 2021

Agreement With Pediatric Suprapatellar Bursa Effusion Assessments by Point-of-Care Ultrasound After Remote Training.

Pediatr Emerg Care 2021 Jan 15. Epub 2021 Jan 15.

From the Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT.

Background: The ease of instruction for point-of-care ultrasound (POCUS) to detect suprapatellar bursa (SPB) effusions in pediatric patients is unknown. Considering in person limitations because of the coronavirus pandemic, strategies for POCUS education by remote learning are necessary.

Methods: We crafted a 90-minute didactic training that was presented via a remote learning format. Read More

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January 2021

An observational study of learning effects of peer-assisted learning tests in COVID-19 pandemic times.

J Dent Educ 2021 Sep 20. Epub 2021 Sep 20.

Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.

Purpose: This study aimed to determine whether peer-assisted learning (PAL) is a more effective learning and test method in terms of oral- and maxillofacial surgery.

Material And Methods: In July 2020, a total of 267 students took a PAL-based exam on fictional patients with surgical issues, in which they had to evaluate two fellow students and were themselves evaluated by two fellow students. The students evaluated their experience with the PAL-based exam through a questionnaire which consisted of five given statements (answer possibilities: agree, disagree, neutral) and two questions (answer possibilities: better, equal, worse) to rate. Read More

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September 2021

Characteristics and Outcomes of the Idiopathic Intracranial Hypertension Treatment in Intrinsic and Extrinsic Stenosis: A Single-Center Experience in China.

Neurol Ther 2021 Sep 20. Epub 2021 Sep 20.

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No. 119, the South Fourth Ring West Road, Fengtai district, Beijing, 100070, China.

Introduction: This study aimed to explore the precipitating factors and evaluate the impact of different stenosis types on treatment outcomes in patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS).

Methods: We recruited patients with IIH who presented with VSS, either intrinsic or extrinsic. We observed the clinical and laboratory findings, and we then compared the outcomes of stenting and medical treatment in different stenosis types. Read More

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September 2021

Satisfaction, Preference and Injection Habits of Switching to 200 Units/ml Insulin Lispro Pen from 100 Units/ml: A Patient Survey in Germany.

Diabetes Ther 2021 Sep 20. Epub 2021 Sep 20.

Klinik und Poliklinik für Endokrinologie, Nephrologie, Rheumatologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.

Introduction: The study was designed to assess patient satisfaction, preferences and injection habits for patients using insulin lispro 200 units/ml pen (IL200) compared to their previously used disposable 100 units/ml mealtime insulin pen ("MTI-100 pen") in Germany.

Methods: A site-based, cross-sectional study involving a self-reported survey and medical record extraction in patients with diabetes currently using IL200 for between 3 and 12 months and had previously used any disposable MTI-100 pen.

Results: Of 114 patients included, 83. Read More

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September 2021

The use of normothermic machine perfusion to rescue liver allografts from expanded criteria donors.

Updates Surg 2021 Sep 20. Epub 2021 Sep 20.

Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS-ISMETT (Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), UPMC (University of Pittsburgh Medical Center), 90127, Palermo, Italy.

The use of expanded criteria donors is one of the strategies used to overcome the gap between the demand for organs and the number of donors. Physicians debate the extent to which marginal grafts can be used. In recent years, normothermic machine perfusion (NMP) has been used to test liver viability before transplantation. Read More

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September 2021

Early results after aortic annuloplasty with a complete external Dacron band.

Gen Thorac Cardiovasc Surg 2021 Sep 20. Epub 2021 Sep 20.

Department of Cardiothoracic Surgery, Oslo University Hospital, Rikshospitalet, Nydalen, Post Office Box 4950, 0424, Oslo, Norway.

Objective: This study evaluates the early results of our initial experience with aortic annuloplasty using a complete external Dacron band in the setting of type Ic or type II aortic regurgitation (AR).

Methods: From May 2017 to August 2019, 16 patients (88% bicuspid aortic valves, no patients with connective tissue disorders) underwent aortic annuloplasty with an external complete Dacron band. Clinical and echocardiographic follow-up was 100% complete. Read More

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September 2021

Factors associated with the antinuclear antibody (ANA) titer of systemic autoimmune rheumatic diseases in ANA-positive patients after treatment: a retrospective study.

Clin Exp Med 2021 Sep 20. Epub 2021 Sep 20.

Center of Clinical Laboratory, School of Medicine, Zhongshan Hospital, Xiamen University, Xiamen, 361004, China.

Antinuclear antibodies (ANAs) are a serological hallmark of systemic autoimmune rheumatic diseases (SARDs); however, few studies have investigated their post-treatment levels. The mechanism by which ANA titers are upregulated in SARDs remains unclear. We assessed factors associated with the ANA titer after treatment. Read More

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September 2021

Outcome of ductus arteriosus stenting including vertical tubular and convoluted tortuous ducts with emphasis on technical considerations.

Egypt Heart J 2021 Sep 20;73(1):83. Epub 2021 Sep 20.

Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University, P. O. Box 80215, Jeddah, 21589, Saudi Arabia.

Background: Ductal stenting is the preferred method of securing adequate pulmonary blood flow in patients with duct-dependent pulmonary circulation. The main limitation in most centers is the difficult vertical tubular or convoluted ducts that represent real challenges to interventional pediatric cardiologists. We present our experience in patent ductus arteriosus (PDA) stenting with some technical tips to overcome difficulties, especially in stenting tortuous or long tubular ducts. Read More

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September 2021

Image-guided confirmation of a precision pull-through procedure during laparoscopically assisted anorectoplasty in an open MRI operating theater: first application in an infantile case with anorectal malformation.

Surg Case Rep 2021 Sep 20;7(1):211. Epub 2021 Sep 20.

Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima City, 890-8520, Japan.

Background: Image-guided surgery with an open magnetic resonance imaging (MRI) system is applied for brain tumors in the neurosurgery field, but has rarely been reported in pediatric surgery. We report our initial experience of intraoperative confirmation of precision rectal pull-through during laparoscopically assisted anorectoplasty (LAARP) in an open MRI operating theater for pediatric patients with anorectal malformation (ARM).

Case Presentation: A 3. Read More

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September 2021

Peripartal pain perception and pain therapy: introduction and validation of a questionnaire as a quality instrument.

Arch Gynecol Obstet 2021 Sep 20. Epub 2021 Sep 20.

Department of Obstetrics, Division of Prenatal Diagnostics and Fetal Physiology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.

Background: Labor pain is difficult to measure. The aim of this proof-of-concept study is to implement and test a questionnaire assessing pain sensation during and after vaginal deliveries. Its key aspect is a highly standardized survey of patient-reported outcome (PRO) by staff not involved in routine care. Read More

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September 2021

Transvaginal repair of vesicouterine fistulae: our experience of three cases.

Int Urogynecol J 2021 Sep 20. Epub 2021 Sep 20.

Department of Urology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

Introduction And Hypothesis: Surgical repair of vesicouterine fistula (VUF) can be performed through transvaginal and transabdominal routes. Transvaginal repair of VUF has been rarely reported. This study is aimed at demonstrating the feasibility and experience of transvaginal repair of VUF, and presents a step-by-step concrete surgical technique. Read More

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September 2021

Exploring Issues and Challenges of Leadership among Early Career Doctors in Nigeria Using a Mixed-Method Approach: CHARTING Study.

Eur J Investig Health Psychol Educ 2020 Feb 14;10(1):441-454. Epub 2020 Feb 14.

Obafemi Awolowo Teaching Hospital, Complex, Ile Ife 17153, Nigeria.

(1) Background: leadership behaviour is a poorly explored phenomenon among early-career doctors (ECDs). Good leadership is vital in maximising the effective management of patients in a clinical setting. While a good number of studies, though with small sample surveys, have researched the role of leadership in clinical setting quantitatively, qualitative investigations are yet to be done in Nigeria. Read More

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February 2020

Automated Size Recognition in Pediatric Emergencies Using Machine Learning and Augmented Reality: Within-Group Comparative Study.

JMIR Form Res 2021 Sep 20;5(9):e28345. Epub 2021 Sep 20.

GECKO Institute, Heilbronn University of Applied Sciences, Heilbronn, Germany.

Background: Pediatric emergencies involving children are rare events, and the experience of emergency physicians and the results of such emergencies are accordingly poor. Anatomical peculiarities and individual adjustments make treatment during pediatric emergency susceptible to error. Critical mistakes especially occur in the calculation of weight-based drug doses. Read More

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September 2021

Medical Trauma in LGBTQIA Youth: Adapting Trauma-Informed Affirming Clinical Practices.

Authors:
Natalia Ramos

Pediatr Ann 2021 Sep 1;50(9):e379-e383. Epub 2021 Sep 1.

Lesbian, gay, bisexual, transgender, queer and/or questioning, intersex, and asexual (LGBTQIA) youth are more likely than cisgender heterosexual youth to experience traumatic stress across all social systems, including within family, school, and health care settings. LGBTQIA youth may be particularly susceptible to traumatic stressors associated with medical illness or injury and health care, due to both to higher baseline levels of stress and adversity and unique identity-linked stressors pervasive across systems of care. Pediatric providers can greatly impact mental health in their LGBTQIA patients by providing trauma-informed care that is affirming of gender and sexual identities. Read More

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September 2021

Treating chronic oedema of the lower limb using circular knit garments: how garment characteristics affect outcomes.

Br J Community Nurs 2021 Oct;26(Sup10):S22-S28

Lymphoedema Clinical Nurse Specialist, St Teresa's Hospice, Darlington.

The use of compression therapy to treat chronic oedema of the lower limbs can be a challenge, especially when this is undertaken by clinicians who have limited experience and knowledge of the theoretical principles which underpin its use in clinical practice. This articles aims to discuss the reasoning which underpins the use of compression hosiery in the management of lymphoedema and how this understanding can improve treatment outcomes and reduce the burden of disease on patients and clinical resources. Read More

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October 2021

Clinical management of withdrawal from benzodiazepine anxiolytic and hypnotic medications.

Authors:
David S Baldwin

Addiction 2021 Sep 20. Epub 2021 Sep 20.

Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.

Benzodiazepines continue to be prescribed widely in the management of patients with insomnia or anxiety disorders, despite the availability and acceptability of alternative pharmacological and psychological treatments. Many patients will experience adverse effects during treatment and considerable distress when the dosage is reduced and stopped. Management of benzodiazepine withdrawal includes measures to prevent the development of dependence, careful attention to underlying medical conditions, medication consolidation and gradual dosage reduction, accompanying psychological interventions, occasional prescription of concomitant medication, and relapse prevention with on-going support to address psychosocial stressors. Read More

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September 2021

Psychological crisis and emergency intervention for frontline critical care workers during the COVID-19 pandemic.

J Clin Nurs 2021 Sep 20. Epub 2021 Sep 20.

Hospital Comarcal Santa Ana de Motril (Granada), Creator and director of the International Research Project for the Humanization of Health Care, Proyecto HU-CI, Madrid, Spain.

Aim: To explore the main feelings and coping strategies among frontline critical care workers during the first phase of the COVID-19 pandemic and to evaluate the level of satisfaction after a psychological crisis and emergency intervention.

Background: The health crisis brought about by the COVID-19 pandemic has exposed critical care workers to an intense physical and emotional burden. Scientific research recommends psychological crisis and emergency interventions during the acute phase to help cope with the situation and prevent emotional side effects. Read More

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September 2021

Assessing gender differences among presumed and diagnosed patients with pulmonary TB: observations from Guinea-Bissau.

Trans R Soc Trop Med Hyg 2021 Sep 20. Epub 2021 Sep 20.

Ban dim Health Project, INDEPTH Network, Apartado 861, 1004 Bissau Codex, Guinea-Bissau.

Background: Globally, more males than females are diagnosed with pulmonary TB (PTB); however, the cause of this gender disparity remains unknown. We aimed to assess gender differences in an observational cohort of patients with presumed PTB (prePTB) at the Bandim Health Project, Guinea-Bissau.

Methods: Adult patients with signs and symptoms suggestive of PTB seeking medical care were invited to participate and were referred to comprehensive diagnostic work-up. Read More

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September 2021

Pisa syndrome: Pathophysiology, physical rehabilitation and falls risk.

NeuroRehabilitation 2021 Sep 15. Epub 2021 Sep 15.

Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, Poland.

Background: Pisa syndrome (PS) is a postural disorder characterised by lateral flexion of the spine (>  10°), predisposing the affected individuals to falls, and contributing to increased mortality in neurodegenerative diseases.

Objective: An overview of currently applied therapeutic management options, primarily focused on specifically structured rehabilitation exercises, in conjunction with falls-risk assessment in the individuals affected by PS.

Methods: A narrative literature review, augmented with the authors' own experience in physical rehabilitation management. Read More

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September 2021

MRI-guided percutaneous thermoablation as first-line treatment of recurrent hepatic malignancies following hepatic resection: single center long-term experience.

Int J Hyperthermia 2021 ;38(1):1401-1408

Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Tübingen, Germany.

Purpose: Hepatic recurrence of liver malignancies is a leading problem in patients after liver resection with curative intention. Thermoablation is a promising treatment approach for patients after hepatic resection, especially in liver-limited conditions. This study aimed to investigate safety, survival, and local tumor control rates of MRI-guided percutaneous thermoablation of recurrent hepatic malignancies following hepatic resection. Read More

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January 2021

Improving Caregiver Health through Systematic Assessment and a Tailored Plan of Care.

West J Nurs Res 2021 Sep 18:1939459211045432. Epub 2021 Sep 18.

Kaiser Foundation Rehabilitation Center, Kaiser Permanente Vallejo Medical Center, Vallejo, CA, USA.

Caregivers often experience strain and negative effects on their well-being. We tested the effects of a caregiver assessment and tailored care plan for caregivers of patients transitioning home from an inpatient rehabilitation facility (IRF), a study involving two groups: usual care ( = 225) (preimplementation) and intervention (postimplementation) ( = 215). Caregivers in the intervention group were assessed using the 25-item self-reported Preparedness Assessment for the Transition Home during the IRF stay. Read More

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September 2021

Psychological Interventions for the Treatment of Chronic Pain in Adults.

Psychol Sci Public Interest 2021 Sep;22(2):52-95

VA Connecticut Healthcare System, West Haven, Connecticut.

The high prevalence and societal burden of chronic pain, its undertreatment, and disparities in its management have contributed to the acknowledgment of chronic pain as a serious public-health concern. The concurrent opioid epidemic, and increasing concern about overreliance on opioid therapy despite evidence of limited benefit and serious harms, has heightened attention to this problem. The biopsychosocial model has emerged as the primary conceptual framework for understanding the complex experience of chronic pain and for informing models of care. Read More

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September 2021