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https://www.readbyqxmd.com/read/28303525/failed-epilepsy-surgery-is-this-the-end
#1
REVIEW
Riëm El Tahry, Irene Zhong Wang
Resective epilepsy surgery can lead to sustained seizure control in 70-80% of patients evaluated for epilepsy surgery, indicating that up to 30% of patients still have recurrent seizures after surgery. Definitions of failed epilepsy surgery vary amongst studies. This review focuses on seizure outcome predictors after reoperation, possible mechanisms of failure and best management for this difficult patient population.
March 16, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28302612/difficult-lumbar-puncture-pitfalls-and-tips-from-the-trenches
#2
REVIEW
P A Hudgins, A J Fountain, P R Chapman, L M Shah
Lumbar puncture has, for many years, been the responsibility of the internal medicine physician or the neurologist. As more patients have undergone spine surgery and with the current increase in body mass index of the general population, the radiologist has been consulted with increasing frequency to perform lumbar puncture with fluoroscopic guidance. Radiology, in fact, is now the dominant overall provider of lumbar puncture procedures. The procedure is more difficult when the needle length increases, and if fluoroscopy is used, landmarks are more difficult to visualize with increasing subcutaneous fat...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28283833/managing-difficult-patients-roles-of-psychologists-in-the-age-of-interdisciplinary-care
#3
William N Robiner, Megan L Petrik
Various problems can occur during encounters between health providers and patients. In some instances, clinicians attribute these problems to patients being "difficult." However, clinicians' perception of difficulties in the clinical encounter are also influenced by: clinicians' own attitudes, thoughts, and behavior; the specific setting in which patient and clinician interact; and properties of the healthcare organization in which they are embedded. This article explores how psychologists in medical settings can serve as a resource that: improves patient care for difficult patients; supports provider wellness; provides relevant education to clinical providers; and reduces the stress that difficult patients place on the healthcare system...
March 10, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/28279404/strategies-for-hemodialysis-access-a-vascular-surgeon-s-perspective
#4
Larry A Scher, Saadat Shariff
Problems related to hemodialysis access are a significant cause of morbidity and mortality in patients with end-stage renal disease. Physicians of all specialties who are involved in the placement and maintenance of vascular access for hemodialysis must have a long-term strategy for sequential placement of autogenous fistulas, transpositions, and prosthetic grafts to preserve access sites and to avoid long-term use of tunneled dialysis catheters. The Fistula First and KDOQI initiatives have provided strategies and algorithms for access placement in patients with chronic kidney disease...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28276847/individual-interpersonal-and-organisational-factors-of-healthcare-conflict-a-scoping-review
#5
Sara Kim, Naike Bochatay, Annemarie Relyea-Chew, Elizabeth Buttrick, Chris Amdahl, Laura Kim, Elise Frans, Matthew Mossanen, Azhar Khandekar, Ryan Fehr, Young-Mee Lee
Unresolved conflicts among healthcare professionals can lead to difficult patient care consequences. This scoping review examines the current healthcare literature that reported sources and consequences of conflict associated with individual, interpersonal, and organisational factors. We identified 99 articles published between 2001 and 2015 from PubMed, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medical Database. Most reviewed studies relied on healthcare professionals' perceptions and beliefs associated with conflict sources and consequences, with few studies reporting behavioural or organisational change outcomes...
February 22, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28272004/surgical-outcomes-post-neoadjuvant-chemotherapy-in-stage-iv-cancers-of-oral-cavity
#6
(no author information available yet)
AIM: To know the effect of neoadjuvant chemotherapy on surgical outcomes (R1 resections, post-operative complications, recurrence and follow up) in Stage IV borderline operable cancers of oral cavity. MATERIALS AND METHODS: Patients in group A (n=45) were those who were referred for neoadjuvant chemotherapy (NACT) with an intention to operate at a later date. These were compared with 45 patients of group B who were operated upfront. All 90 patients have stage IV squamous cell carcinoma of oral cavity...
January 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28185307/professional-interpersonal-dynamics-and-burnout-in-european-transplant-surgeons
#7
Michelle T Jesse, Marwan Abouljoud, Anne Eshelman, Chantal De Reyck, Jan Lerut
Burnout within the health professions has become an increasingly important topic. Evidence suggests there are differences in burnout across different countries. Research has yet to examine burnout in transplant surgeons throughout Europe. METHODS: A cross-sectional survey of transplant surgeons across Europe. Survey included sociodemographics, professional characteristics, frequency and discomfort with difficult patient interactions, decisional autonomy, psychological job demands, support (coworker, supervisor, and hospital administration), and burnout including emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA)...
February 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28164254/utility-of-18f-sodium-fluoride-pet-ct-imaging-in-the-evaluation-of-postoperative-pain-following-surgical-spine-fusion
#8
D Pouldar, S Bakshian, R Matthews, V Rao, M Manzano, S Dardashti
STUDY DESIGN: A retrospective case review of patients who underwent 18F sodium fluoride PET/CT imaging of the spine with postoperative pain following vertebral fusion. OBJECTIVE: To determine the benefit of 18F sodium fluoride PET/CT imaging in the diagnosis of persistent pain in the postoperative spine. The diagnosis of pain generators in the postoperative spine has proven to be a diagnostic challenge. The conventional radiologic evaluation of persistent pain after spine surgery with the use of plain radiographs, MRI, and CT can often fall short of diagnosis in the complex patient...
February 6, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28150406/preoperative-assessment-of-factors-associated-with-difficulty-in-performing-total-laparoscopic-hysterectomy
#9
Ako Saito, Tetsuya Hirata, Kaori Koga, Masashi Takamura, Shinya Fukuda, Kazuaki Neriishi, Gia Pastorfide, Miyuki Harada, Yasushi Hirota, Osamu Wada-Hiraike, Tomoyuki Fujii, Yutaka Osuga
AIM: Our objective was to determine the preoperative factors associated with difficulty in total laparoscopic hysterectomy (TLH). METHODS: This retrospective clinical study included 157 patients who underwent TLH for leiomyoma or adenomyosis between 2009 and 2013. All patients underwent magnetic resonance imaging (MRI) before surgery. We categorized patients as 'difficult' if the operation time was > 243 min, if total blood loss was > 500 mL, or if conversion to laparotomy was necessary...
February 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27994840/intraspinal-lumbar-juxtaarticular-cyst-treatment-through-ct-guided-percutaneus-induced-rupture-results-in-a-favorable-patient-outcome
#10
Adisa Kursumovic, Richard Bostelmann, Maria Gollwitzer, Stefan Rath, Hans Jakob Steiger, Athanasios K Petridis
Juxta-articular cysts are synovial cysts originating from the facet joints or the flava ligaments. If they grow intra-spinally they can compress nervous structures and cause a variety of symptoms. Micro-neurosurgery is usually the treatment of choice. Alternatively to surgical treatment the cyst can be approached and treated with a CT guided percutaneous injection inducing rupture. After fulfilling strict selection criteria twenty patients (25% of all treated lumbar synovial cyst patients), were treated minimally invasive by this method from 2010-2016...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27956233/graft-augmentation-versus-bridging-for-large-to-massive-rotator-cuff-tears-a-systematic-review
#11
REVIEW
Yohei Ono, Diego Alejandro Dávalos Herrera, Jarret M Woodmass, Richard S Boorman, Gail M Thornton, Ian K Y Lo
PURPOSE: To systematically review the literature on the healing rates and clinical outcomes of the 2 different graft indications (i.e., augmentation vs bridging) during rotator cuff repair. METHODS: A systematic literature review was performed for clinical studies of rotator cuff repair using grafts for large to massive tears. The primary outcome was tendon healing on either magnetic resonance imaging or ultrasound. The secondary outcomes included visual analog scale for pain, American Shoulder and Elbow Surgeons score, and University of California at Los Angeles score, and forward elevation...
March 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27940771/the-aap-resilience-in-the-face-of-grief-and-loss-curriculum
#12
Janet R Serwint, Susan Bostwick, Ann E Burke, Annamaria Church, Albina Gogo, Dena Hofkosh, Marta King, Jennifer Linebarger, Megan E McCabe, Margaret Moon, Amanda Osta, Deborah T Rana, O J Sahler, Keely Smith, Florence Rivera, Constance Baldwin
A career in pediatrics can bring great joy and satisfaction. It can also be challenging and lead some providers to manifest burnout and depression. A curriculum designed to help pediatric health providers acquire resilience and adaptive skills may be a key element in transforming times of anxiety and grief into rewarding professional experiences. The need for this curriculum was identified by the American Academy of Pediatrics Section on Medical Students, Residents and Fellowship Trainees. A working group of educators developed this curriculum to address the professional attitudes, knowledge, and skills essential to thrive despite the many stressors inevitable in clinical care...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27923216/efficacy-of-a-cellular-bone-allograft-for-foot-and-ankle-arthrodesis-and-revision-nonunion-procedures
#13
Travis J Dekker, Peter White, Samuel B Adams
BACKGROUND: Bone graft substitutes are often required in patients at risk for nonunion, and therefore, an allograft that most closely mimics an autograft is highly sought after. This study explored the utility and efficacy of a cellular bone allograft used for foot and ankle arthrodesis and revision nonunion procedures in a patient population at risk for nonunion. METHODS: An institutional review board-approved retrospective review of consecutive patients who underwent arthrodesis and revision nonunion procedures with a cellular bone allograft was performed at a single academic institution...
March 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27888946/difficult-doctors-difficult-patients-building-empathy
#14
Patricia F Anderson, Elise Wescom, Ruth C Carlos
Effective doctor-patient communication facilitates the therapeutic relationship, promotes patient physical and mental health, and improves physician satisfaction. Methods of teaching effective communication use a range of techniques, typically combining didactic instruction with simulated communication encounters and reflective discussion. Rarely are patients and physicians exposed to these instructions as colearners. The evidence for the utility of graphic stories, comics, and cartoons to improve patient comprehension and self-regulation is small but encouraging...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27884908/books-the-frayed-consultation-model-for-doctors-dealing-with-unreasonable-demands-from-difficult-patients-a-communication-skills-guide-for-stressed-gps-on-how-to-survive-doctor-patient-conflict-to-yield-or-not-to-yield
#15
Shazia Khan
No abstract text is available yet for this article.
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27874846/communications-and-relationships-between-patient-and-nurse-in-intensive-care-unit-knowledge-knowledge-of-the-work-knowledge-of-the-emotional-state
#16
Chiara Foà, Lisa Cavalli, Alessia Maltoni, Nicoletta Tosello, Chiara Sangilles, Ilaria Maron, Marina Borghini, Giovanna Artioli
BACKGROUND AND AIM: In an Intensive Care Unit (ICU) the communication between nurse and patient, the core of the care, is often hindered by patient's cognitive alterations and critical situation, by devices employed for the mechanical ventilation, and by the clinical and care-giving setting. How to overcome these barriers? How is the relational and communicative approach between nurse and patient unable to express him or herself to be managed? The available literature reveals that studies on communication with difficult patients, such as those treated in ICU are currently scarce...
November 22, 2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27777876/transanal-total-mesorectal-excision-myths-and-reality
#17
EDITORIAL
Nicolas C Buchs, Marta Penna, Alexander L Bloemendaal, Roel Hompes
Transanal total mesorectal excision (TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions...
October 10, 2016: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27772554/what-s-difficult-a-multi-stage-qualitative-analysis-of-secondary-care-specialists-experiences-with-medically-unexplained-symptoms
#18
Anke Maatz, Megan Wainwright, Andrew J Russell, Jane Macnaughton, Yan Yiannakou
BACKGROUND: The term 'difficult' is pervasively used in relation to medically unexplained symptoms (MUS) and patients with MUS. This article scrutinises the use of the term by analysing interview data from a study of secondary care specialists' experiences with and attitudes towards patients suffering from MUS. DESIGN: Qualitative design employing semi-structured open-ended interviews systematically analysed in three stages: first, data were analysed according to the principles of content analysis...
November 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27728916/lobar-collapse-therapy-using-endobronchial-valves-as-a-new-complementary-approach-to-treat-cavities-in-multidrug-resistant-tuberculosis-and-difficult-to-treat-tuberculosis-a-case-series
#19
Lorenzo Corbetta, Ariela Tofani, Flavio Montinaro, Lucio Michieletto, Loris Ceron, Chiara Moroni, Pier Giorgio Rogasi
BACKGROUND: The poor treatment outcomes of multidrug-resistant tuberculosis (TB) and the emergence of extensively drug-resistant TB and extremely and totally drug-resistant TB highlight the urgent need for new antituberculous drugs and other adjuvant treatment approaches. OBJECTIVES: We have treated cavitary tuberculosis by the application of endobronchial one-way valves (Zephyr®; Pulmonx Inc., Redwood City, Calif., USA) to induce lobar volume reduction as an adjunct to drug treatment...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27726880/non-crosslinked-porcine-acellular-dermal-matrix-in-pediatric-abdominal-wall-reconstruction-a-case-series
#20
Richard W Siy, Rachel E Pferdehirt, Shayan A Izaddoost
INTRODUCTION: The use of biologic mesh where native tissue deficiencies limit reconstructive options has been well documented in the adult population, with increasing use to address the special requirements of complex abdominal wall reconstruction. There is, however, little documented evidence as to the safety and efficacy of these products in the pediatric population. METHODS: This retrospective case series details 5 pediatric cases of complicated abdominal hernia repair with Strattice®, a non-crosslinked porcine acellular dermal matrix...
September 23, 2016: Journal of Pediatric Surgery
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