Physical Illness: The Family and the Physician

When confronted by the specific stress of a close relative\u27s illness, the family members\u27 reactions may be schematically divided into three stages: 1) disorganization; 2) reintegration; and 3) adjustment. Either disorganization can be intensified or adjustment can be fostered, depending on the physician\u27s understanding of the feelings the family members experience and his willingness and ability to be helpful. The family members\u27 responses, in turn, will influence the patient\u27s reaction to illness or his recovery and rehabilitation. Accordingly, good medical practice requires that the physician include the family in his total treatment plan whenever possible

The role of open abdomen in non-trauma patient : WSES Consensus Paper

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.Peer reviewe