Vacuum-assisted closure therapy after resection of giant basal cell carcinoma of the scalp

Management of complicated wounds is a challenge in head and neck reconstruction. Although the negative pressure wound therapy or wound vacuum-assisted closure has been widely used in complicated wounds and shows promising results, its application in the head and neck region after reconstruction for the head and neck cancer is rarely presented. A 77-year-old woman underwent a radical resection of an extensive basal cell carcinoma of the scalp and forehead involving the periosteum, where classic reconstruction was difficult, but successfully treated with negative pressure wound therapy. Negative pressure wound therapy is an efficacious tool in cases of complex and extensive defects, when we expect immediate reconstruction with poor results, as would be probable with this scalp lesion.info:eu-repo/semantics/publishedVersio

Videoconferencing and telementoring about dementia care: evaluation of a pilot model for sharing scarce old age psychiatry resources

While videoconferencing, telementoring, and peer support have been shown to enhance services in some instances, there has been no research investigating the use of these technologies in supporting professionals managing clients with dementia. The objective of this research was to evaluate expansion of an old age psychiatry consultation service and pilot test a model to improve medical supervision and clinical governance for staff within regional and remote areas using remote information technology. The design was a mixed methods (qualitative and quantitative) evaluation using before, mid-point and post-implementation semi-structured interviews and questionnaires to examine orientation, acceptance, and impact underpinned by theoretical approaches to evaluation. Education evaluations used a Likert style response template. Participants were 18 dementia service staff, including staff from linked services and old age psychiatrists. Qualitative interviews addressed the pilot implementation including: expectations, experiences, strategies for improving the pilot, and perceived impact on work practice and professional development opportunities. There was high satisfaction with the program. The case conference process contributed to perceived improved outcomes for clients, family, and staff. Clinicians perceived improvement in family carer and staff carer stress and their confidence in managing clients with behavioral and psychological symptoms of dementia (BPSD). Thematic analysis indicated that the pilot enhanced professional development, decreased travel time, and improved team cohesion. Given the increasing aging population in regional, rural, and remote areas, initiatives using videoconferencing and telementoring will help to develop a confident and skilled workforce. This pilot program was found to be acceptable and feasible. Potential benefits for clients and family carers should be examined in future resesarch

Work activities at increased risk of traumatic injuries: an integrated preventive approach

Included in the scope of workplace safety is that relating to potential accidents, i.e. the harmful consequences for human health crossed with the work environment factor. In the study of the determinism of these accidental events, it is important to achieve a biomechanical balance between two main elements: the human and the work environment (consisting of the physical, chemical and environmental factors, i.e. the equipment and what generates its use). Considering the most recent statistically recorded incidents, our analysis has focused on the accident sphere proper, where an imbalance in the above-mentioned binomial triggers the activation of multiple disciplines that actively and pro-actively study the event and assess its sequelae, in all possible facets (economic, engineering, clinical, medical-legal)

Wigner density of a rigid rotator

We show that the Wigner density of the rigid rotator, in an appropriate, i.e., four-dimensional, phase space, is positive. This result holds in the ground state (S state), and also in the thermal mixture state at all finite temperatures. We discuss the implications of our result for the description of angular momentum in quantum mechanics; in particular, we reexamine, in the light of this new evidence, the suggestion made by Einstein and Stern [Ann. Phys. 40, 551 (1913)] that there is a nontrivial distribution of angular momentum in the S state

Atypical presentation of sigmoid carcinoma

Colorectal carcinoma is common worldwide and its metastasis represents the main cause of mortality related to the disease. Inguinal metastization of this tumor has been considered almost impossible, owing to colon anatomy and its cranial lymphatic drainage. We report the case of a 63-year-old man submitted to laparoscopical sigmoid colectomy, due a sigmoid adenocarcinoma. During follow-up, a right inguinal lymphadenopathy with 25 mm was detected. Fine needle aspiration biopsy revealed that it was a colon adenocarcinoma metastasis, and thus the patient underwent an inguinal lymphadenectomy. The histological study confirmed metastatic adenocarcinoma of the colon and the patient was submitted to 5-fluouracil and oxaliplatin chemotherapy. This case coursed with metastasis to the right inguinal region; although, the pathophysiological mechanism involved is difficult to understand. There are no solid data for the management of these patients. Inguinal lymphadenectomy and chemotherapy, proved to be effective.info:eu-repo/semantics/publishedVersio

Critical sets of nonlinear Sturm-Liouville operators of Ambrosetti-Prodi type

The critical set C of the operator F:H^2_D([0,pi]) -> L^2([0,pi]) defined by F(u)=-u''+f(u) is studied. Here X:=H^2_D([0,pi]) stands for the set of functions that satisfy the Dirichlet boundary conditions and whose derivatives are in L^2([0,pi]). For generic nonlinearities f, C=\cup C_k decomposes into manifolds of codimension 1 in X. If f''0, the set C_j is shown to be non-empty if, and only if, -j^2 (the j-th eigenvalue of u -> u'') is in the range of f'. The critical components C_k are (topological) hyperplanes.Comment: 6 pages, no figure