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https://www.readbyqxmd.com/read/27927508/kyphectomy-in-children-with-severe-myelomeningocele-related-kyphosis
#1
R N Dunn, L N Bomela
STUDY DESIGN: Retrospective review of prospectively maintained database. OBJECTIVES: To review myelomeningocele patients with severe kyphosis undergoing kyphectomy surgery in terms of complications and clinical and radiographic outcomes. SUMMARY OF BACKGROUND DATA: Because of posterior element abnormality in myelomeningocele, the extensor muscles act as perverted flexors, driving progressive kyphosis that resulted in sitting, respiratory, and skin breakdown problems...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27913079/rash-decisions-an-approach-to-dangerous-rashes-based-on-morphology
#2
Jamie Santistevan, Brit Long, Alex Koyfman
BACKGROUND: Rash is a common complaint in the emergency department. Many causes of rash are benign; however, some patients may have a life-threatening diagnosis. OBJECTIVE: This review will present an algorithmic approach to rashes, focusing on life-threatening causes of rash in each category. DISCUSSION: Rash is common, with a wide range of etiologies. The differential is broad, consisting of many conditions that are self-resolving. However, several conditions associated with rash are life threatening...
November 29, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27906732/safety-profile-of-children-in-an-enclosure-bed
#3
Eileen Sherburne, Julia A Snethen, Sheryl Kelber
PURPOSE: Pediatric nurses care for many children in the hospital setting whose behavioral challenges can impact safety. One intervention utilized to prevent injury and improve safety when caring for this population of children has been the enclosure bed. Scant information was found in the literature that discusses the use of the enclosure bed in the pediatric setting. The purpose of this article is to examine the use of the enclosure bed in the pediatric setting. A secondary aim is to identify the population of children where an enclosure bed was implemented and the safety factors associated with use of the enclosure bed...
January 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/27864837/risk-factors-for-non-purulent-leg-cellulitis-a-systematic-review-and-meta-analysis
#4
REVIEW
M Quirke, F Ayoub, A McCabe, F Boland, B Smith, R O'Sullivan, A Wakai
Non-purulent cellulitis is an acute bacterial infection of the dermal and subdermal tissues that is not associated with purulent drainage, discharge or abscess. The objective of this systematic review and meta-analysis (SRMA) was to identify and appraise all controlled observational studies that have examined risk factors for the development of non-purulent cellulitis of the leg (NPLC). A systematic literature search of electronic databases and grey literature sources was performed in July 2015. The Newcastle-Ottawa Scale (NOS) was used to assess methodological quality of included studies...
November 18, 2016: British Journal of Dermatology
https://www.readbyqxmd.com/read/27852504/bilateral-rib-based-distraction-to-the-pelvis-for-the-management-of-congenital-gibbus-deformity-in-the-growing-child-with-myelodysplasia
#5
John T Smith
BACKGROUND: Congenital gibbus deformity of the spine associated with myelodysplasia is a challenging problem in the growing child and is commonly associated with skin breakdown and chronic infection. Surgical solutions including kyphectomy, flap closure of the skin, and early spinal fusion are associated with a high rate of complications and, ultimately, a short trunk due to stoppage of spinal growth. The purpose of this article is to describe our early results in using a rib-based distraction to the pelvis without vertebral resection and fusion to manage this deformity...
January 2016: Spine Deformity
https://www.readbyqxmd.com/read/27843731/case-report-of-a-pressure-ulcer-occurring-over-the-nasal-bridge-due-to-a-non-invasive-ventilation-facial-mask
#6
Farooq A Rathore, Faria Ahmad, Muhammad Umar U Zahoor
Non-invasive ventilation (NIV) is used in patients with respiratory failure, sleep apnoea, and dyspnoea related to pulmonary oedema. NIV is provided through a facial mask. Many complications of NIV facial masks have been reported, including the breakdown of facial skin. We report a case of an elderly male admitted with multiple co-morbidities. The facial mask was applied continuously for NIV, without any relief or formal monitoring of the underlying skin. It resulted in a Grade II pressure ulcer. We discuss the possible mechanism and offer advice for prevention of such device-related pressure ulcers...
October 3, 2016: Curēus
https://www.readbyqxmd.com/read/27825900/relational-victimization-and-depressive-symptoms-the-role-of-autonomic-nervous-system-reactivity-in-emerging-adults
#7
Leigh Ann Holterman, Dianna K Murray-Close, Nicole L Breslend
The goal of the current study was to investigate the association between relational victimization, defined as being the target of aggressive acts that damage relationships (e.g., gossip, social exclusion) and depressive symptoms during the relatively understudied developmental period of emerging adulthood. In addition, as individual differences in stress reactivity may influence the outcomes associated with victimization by peers, the moderating roles of sympathetic nervous system (SNS; as measured by skin conductance reactivity) and parasympathetic nervous system (PNS; as measured by respiratory sinus arrhythmia) reactivity to social and non-social stressors were examined...
November 5, 2016: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/27810611/management-of-skin-defect-following-resection-of-stage-iv-scalp-melanoma-a-case-report
#8
Yana Puckett, Eileen Bui, Sharmila Dissanaike
INTRODUCTION: Surgical defect left following excision of a large and neglected scalp melanoma of can pose a significant challenge for the surgeon. Scalp reconstruction encompasses options such as skin flaps, grafts, and various mechanical techniques. In scalp excision that involves dissection beyond the galea, skin grafts and flaps may not take well and not enough tissue may be available for a skin flap. PRESENTATION OF CASE: We present the case of a 64 year-old male with a giant scalp melanoma...
October 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27808636/non-pharmacological-interventions-for-the-prevention-of-venous-thromboembolism-a-literature-review
#9
Esther Hanison, Kevin Corbett
AIM: To assess the relative clinical efficacy of different forms of non-pharmacological prophylaxis, intermittent pneumatic compression and graduated compression stockings in reducing the incidence of venous thromboembolism (VTE) in patients hospitalised following acute stroke. METHOD: This was a thematic synthesis of literature retrieved from a structured bibliographic search of: Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Summon, British Nursing Index, NHS Evidence, Internurse...
October 19, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27800186/modified-lower-pole-autologous-dermal-sling-for-implant-reconstruction-in-women-undergoing-immediate-breast-reconstruction-after-mastectomy
#10
Pankaj G Roy
Background. Autologous dermal sling with wise pattern skin reducing mastectomy allows one-stage implant reconstruction in women with large and ptotic breasts needing mastectomy for cancer or risk reduction. However, this technique is not suitable for women who lack ptosis and also carries risk of T-junction breakdown. Method. We have performed one-stage nipple sparing mastectomies with implant reconstruction in 5 women (8 breasts) by modifying the autologous dermal sling approach. All these women had small to moderate breasts with no ptosis or pseudoptosis...
2016: International Journal of Breast Cancer
https://www.readbyqxmd.com/read/27783142/revisiting-the-anterior-rectus-sheath-repair-for-incisional-hernia-a-10-year-experience
#11
Erica I Hodgman, Mark J Watson
BACKGROUND: Surgeons continue to seek an incisional hernia repair technique which minimizes cost and morbidity while maximizing durability. We present a single surgeon's experience with a technique described by N.L. Browse and J.P. Chevrel in 1979. METHODS: The Chevrel/Browse repair consists of a bilateral anterior rectus sheath release, hernia sac imbrication, bilateral rectus complex medialization, and repair reinforcement with an anterior prosthetic mesh. Data were collected on all patients who underwent herniorrhaphy between April 2003 and April 2013...
October 25, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27778451/management-of-extremely-hard-to-heal-extremity-wounds-with-severe-life-threatening-complications
#12
Aijia Cai, Anja M Boos, Andreas Arkudas, Raymund E Horch
The introduction of neoadjuvant radiotherapy has allowed limb-preserving surgical treatment in patients with extremity soft tissue sarcoma, and the overall prognosis of this approach is similar to that of limb amputation. The benefits of this treatment, however, are often accompanied with a higher risk of major complications and blood vessel damage because of radiation-induced inflammation and necrosis of the vessel wall. In particular, it is associated with the rupture of large vessels like the femoral artery and more severe complications of wounds located in the proximal lower extremity...
October 25, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27771328/holocrine-secretion-of-sebum-is-a-unique-dnase2-dependent-mode-of-programmed-cell-death
#13
Heinz Fischer, Judith Fumicz, Heidemarie Rossiter, Markus Napirei, Maria Buchberger, Erwin Tschachler, Leopold Eckhart
Sebaceous glands produce sebum via holocrine secretion, a largely uncharacterized mode of programmed cell death that contributes to the homeostasis and barrier function of the skin. To determine the mechanism of DNA degradation during sebocyte cell death, we have inactivated candidate DNA-degrading enzymes by targeted gene deletions in mice. DNase1 and DNase1L2 were dispensable for nuclear DNA degradation in sebocytes. By contrast, epithelial cell-specific deletion of lysosomal DNase2 blocked DNA degradation in these cells...
October 19, 2016: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/27750265/the-pressure-is-on-neonatal-skin-and-nasal-continuous-positive-airway-pressure
#14
Daniele Ottinger, Jamie Hicks, Sarah Wilson, Kim Sperber, Keely Power
BACKGROUND: Premature infants have an increased risk for developing skin breakdown. Perceivably noninvasive interventions may have detrimental effects on the infant's skin. PURPOSE: This case presentation describes an extreme case of nasal breakdown associated with nasal continuous positive airway pressure (nCPAP). METHODS: Highlighted is the vital importance of proper placement, along with appropriate apparatus size, in the efforts to prevent skin breakdown...
December 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27740453/human-immunology-of-tuberculosis
#15
Thomas J Scriba, Anna K Coussens, Helen A Fletcher
Immunology is a central theme when it comes to tuberculosis (TB). The outcome of human infection with Mycobacterium tuberculosis is dependent on the ability of the immune response to clear or contain the infection.In cases where this fails, the bacterium replicates, disseminates within the host, and elicits a pathologic inflammatory response, and disease ensues. Clinical presentation of TB disease is remarkably heterogenous, and the disease phenotype is largely dependent on host immune status. Onward transmission of M...
October 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/27726784/human-immunology-of-tuberculosis
#16
Thomas J Scriba, Anna K Coussens, Helen A Fletcher
Immunology is a central theme when it comes to tuberculosis (TB). The outcome of human infection with Mycobacterium tuberculosis is dependent on the ability of the immune response to clear or contain the infection.In cases where this fails, the bacterium replicates, disseminates within the host, and elicits a pathologic inflammatory response, and disease ensues. Clinical presentation of TB disease is remarkably heterogenous, and the disease phenotype is largely dependent on host immune status. Onward transmission of M...
August 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/27694354/the-abcds-of-managing-morbidly-obese-patients-in-intensive-care-units
#17
Luis A Berrios
More than one-third of the US adult population and 17% of the youth are now obese, and obesity is associated with more than $147 billion a year in health care costs. Critical care nurses should understand the physiological differences and practice guidelines for patients with a body mass index greater than 30. The ABCD approach encompasses key clinical concepts in the management of critically ill obese and morbidly obese patients, including management of airways and breathing, minimizing nurses' back and other injuries, increasing awareness of bias, circulation problems, risks of decubitus ulcers and other skin breakdown, differences in drug calculations and metabolism, limitations in diagnostic equipment and imaging, diet and nutritional recommendations, and concerns with durable medical equipment...
October 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27676110/diaper-dermatitis-what-do-we-do-next
#18
Media Esser
Diaper dermatitis is a major issue among hospitalized infants, leading to increased medical costs, pain, risk for infection, and distress among patients and caregivers. An evidence-based algorithm for prevention and treatment of diaper dermatitis was developed and introduced in a level IV neonatal intensive care unit (NICU). Two cases are discussed as examples of severe diaper dermatitis. The first case demonstrates the final case of severe diaper dermatitis since the introduction of the algorithm. The second case demonstrates a less severe, but equally frustrating, case of diaper dermatitis that occurred after the practice of using the algorithm was established...
October 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27668479/exploring-the-effect-of-educating-certified-nursing-assistants-on-pressure-ulcer-knowledge-and-incidence-in-a-nursing-home-setting
#19
Cathy L Wogamon
The certified nursing assistant (CNA) is the caregiver who frequently identifies the first signs and symptoms of pressure ulcers (PUs) in the long-term care setting. A quality improvement effort was implemented to explore the effect of a 1-hour CNA education program about early identification, treatment, and prevention of PUs on PU knowledge, PU incidence, and PU prevention interventions, including skin checks. All 33 CNAs employed in a care facility for residents 55+ years old were invited to participate. CNA demographic and PU education variables were obtained...
September 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27666105/care-and-management-of-a-stoma-maintaining-peristomal-skin-health
#20
Anna Boyles, Sharon Hunt
It is estimated that around one in 500 people in the UK are living with a stoma, with approximately 21 000 operations that result in stoma formation being performed each year ( Colostomy Association, 2016 ). These people face a unique set of challenges in maintaining the integrity of their peristomal skin. This article explores the normal structure and function of skin and how the care and management of a stoma presents challenges for maintaining peristomal skin health. Particular focus is paid to the incidence of skin problems for those living with a stoma, whether it is temporary or permanent, and the factors that contribute to skin breakdown in this population...
September 22, 2016: British Journal of Nursing: BJN
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