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The evolution of suspected deep tissue injuries from an initial purple bruise to a significant stage III or IV pressure ulcer may be rapid, even with optimal treatment. This case series describes our experience with air-fluidized therapy (AFT) placed upon discovery of suspected deep tissue injury (sDTI) in an acute care setting.

Purpose: To demonstrate that endovenous thermal ablation is not only effective and safe but also a durable treatment in patients with symptomatic varicose veins.Methods: From February 2002 to February 2009, 2354 patients (1836 women; mean age 53 years, range 15–95) with symptomatic varicose veins in 3000 limbs underwent endovenous laser ablation (EVLA) or radiofrequency ablation (RFA). The majority of treated vessels were the great saphenous veins (GSV; 2619, 87.3%); 269 (8.9%) small saphenous veins (SSV) and 112 (3.8%) accessory saphenous veins (ASV) were also treated, all in outpatient procedures under local intra-compartmental anesthesia. An ultrasound evaluation was performed within 2 weeks of the procedure to evaluate vein occlusion, vein wall thickness, and clot extension into the deep vein. In a long-term evaluation involving the first 165 patients treated from February 2002 to January of 2003, 105 (64%) patients [126 (67%) of the 188 eligible limbs] were followed annually with clinical evaluation, duplex ultrasound, and symptom/satisfaction assessment over a mean 6.7 years.Results: Treatment of 3000 limbs involved the use of EVLA in 2841 (2460 GSVs, 269 SSVs, and 112 ASVs) and RFA in 159 GSVs. Post-procedure duplex ultrasound found 57 (2.0%) veins recanalized or incompletely occluded [51 (2%) treated with EVLA and 6 (3.7%) with RFA] in patients treated for GSV or ASV incompetence. In the 269 SSVs treated (all with EVLA), 18 (6.7%) limbs demonstrated incomplete occlusion. Overall, both EVLA and RFA procedures were well tolerated, with minimal complications. In the longitudinal assessment of the 105 patients (126 limbs) participating in annual follow-up for a mean 6.7 years, the overall rate of satisfaction, symptom relief, and absence of varicosities was 86%.Conclusion: Endovenous ablation of saphenous vein has proven to be an effective, safe, and very durable procedure.

Purpose: To evaluate the effectiveness of endovenous treatment of symptomatic varicose veins using the endovenous laser (EVL) or radiofrequency (RF) energy over a >3-year follow-up.Methods: From February 2002 to August 2005, 981 consecutive patients (770 women; mean age 51 years, range 15–90) with symptomatic varicose veins in 1250 lower limbs underwent endovenous ablation of 1149 great saphenous veins (GSV) and 101 small saphenous veins (SSV) under tumescent anesthesia without intravenous sedation or regional anesthesia. There were 990 GSV and 101 SSV procedures using EVL; 159 GSVs were treated with RF energy. An ultrasound evaluation was performed within 2 weeks of the procedure to evaluate occlusion of the vein, wall thickness, and clot extension into the deep venous system. Follow-up from the first 200 procedures in the series included clinical evaluation and duplex ultrasound scanning at 6 and 12 months and annually thereafter.Results: Of the 1149 GSVs treated, 39 (3.4%) recanalizations were seen in 33 of the EVL and 6 of the RF procedures for inadequate treatment as judged by ultrasound. There were 9 (9.0%) failures among the 101 SSVs treated with EVL. Overall, both EVL and RF procedures were well tolerated, with only minor complications. One obese patient with ulcer developed pulmonary embolus on the fourth postoperative day. There were no differences between EVL and RF in efficacy or complications. Follow-up at a mean 3 years (range 30–42 months) in 143 treated limbs showed no neovascularization in the groin.Conclusion: Outcomes with EVL and RF were good, with low complication rates that may be related to the use of local tumescent anesthesia without intravenous sedation.

Explores elements of suffering and the process through which suffering can be transforming. Notes that although inexorable limitations may be placed in our paths, suffering tends to force persons back within themselves, into a place of utter forsakenness. Claims that it is in this place that we learn more about the limits of our humanness and come into a deeper, more conscious relationship with God, with ourselves and with others.

This preliminary study evaluated the concurrent validity of the Thurstone Test of Mental Alertness as a brief intelligence test using the Wechsler Adult Intelligence Scale—Revised as the criterion of adult intellectual achievement. Analyses indicated that the Total score on Thurstone's test was significantly correlated with the standard summary scores as well as with the WAIS—R factor scores. On the Thurstone Test of Mental Alertness scores could accurately predict WAIS—R intelligence for this nonclinical sample of 32 undergraduates. The concurrent validity of the test as a brief intelligence test was inferred and the results were consistent with the range of correlations expected among all measures of global intellectual achievement. Reading comprehension was suggested as a principal factor attenuating the correlation between the two tests.

Focuses on the importance of strategic business communications in a successful consolidation and merger of corporations. Need for business communications to be both strategic and analytical; Objectives that can be used as a guide for communication planning.