Search

Conventional excision of female genital skin cancers has high rates of local recurrence and morbidity. Few publications describe local recurrence rates (LRRs) and patient-reported outcomes (PROs) after Mohs micrographic surgery (MMS) for female genital skin cancers. To evaluate LRRs, PROs, and interdisciplinary care after MMS for female genital skin cancers. A retrospective case series was conducted of female genital skin cancers treated with MMS between 2006 and 2021 at an academic center. The primary outcome was local recurrence. Secondary outcomes were PROs and details of interdisciplinary care. Sixty skin cancers in 57 patients were treated with MMS. Common diagnoses included squamous cell cancer (n = 26), basal cell cancer (n = 12), and extramammary Paget disease (n = 11). Three local recurrences were detected with a mean follow-up of 61.1 months (median: 48.8 months). Thirty-one patients completed the PROs survey. Most patients were satisfied with MMS (71.0%, 22/31) and reported no urinary incontinence (93.5%, 29/31). Eight patients were sexually active at follow-up and 75.0% (6/8) experienced no sexual dysfunction. Most cases involved interdisciplinary collaboration 71.7% (43/60). Limitations include the retrospective single-center design, heterogeneous cohort, and lack of preoperative function data. Incorporating MMS into interdisciplinary teams may help achieve low LRRs and satisfactory function after genital skin cancer surgery. [ABSTRACT FROM AUTHOR]

This case report details a rare instance of a renal jejunal fistula accompanied by tuberculosis (TB) and parasitic infestation in a pediatric patient. It adds to the limited literature on renal fistulas involving the jejunum, particularly those compounded by infectious diseases, highlighting the diagnostic and therapeutic challenges in managing such complex cases. The patient initially presented with flank pain, a discharging sinus in the left flank region, cough, and general malaise, alongside symptoms of anemia. Clinical examination and diagnostics unveiled a non-functioning left kidney with multiple calculi and signs of severe pyelonephritis. However, surgery revealed an unexpected twist—a renal jejunal fistula with worm infestation. The main diagnoses included a renal jejunal fistula, tuberculosis, and parasitic infestation. The patient underwent a left nephrectomy to remove the affected kidney, and the fistula was repaired. Postoperative care involved TB treatment and deworming. The case underscored the necessity of a comprehensive diagnostic approach and readiness for unexpected intraoperative findings. This case highlights the importance of considering infectious diseases in the differential diagnosis of unusual renal or gastrointestinal symptoms, especially in pediatric patients from endemic regions. It demonstrates the necessity of interdisciplinary collaboration in managing rare and complex medical conditions and stresses the need for follow-up to assess long-term outcomes, which was limited in this case due to the patient's non-attendance at scheduled visits. • Rare renal jejunal fistula in pediatric TB and parasites • Worm infestation found during surgery • Managed by nephrectomy, fistula repair, and treatments • Highlights infectious causes in renal pathologies • Shows need for interdisciplinary pediatric care [ABSTRACT FROM AUTHOR]

Intracardial migration of a ventriculoperitoneal (VP) shunt (ICMVP) is a rare complication that has been described in only single case reports. Here we report the successful interdisciplinary management of an ICMVP and provide a review of the relevant literature. A 38-year-old-patient with shunt-dependent hydrocephalus caused due to a Blake's pouch cyst presented in our hydrocephalus outpatient clinic with thoracic pain and nocturnal cough at 7 months after VP shunt implantation (with initially a proper location on computed tomography scan of the head and X-ray of the abdomen). A new X-ray of the abdomen and the thorax revealed a dislocated shunt with migration of the distal catheter into the superior cava vein, right atrium, and right heart ventricle, with some loops in both pulmonary arteries. The catheter was successfully removed by an interdisciplinary team in general anesthesia under ultrasound, X-ray guidance, and cardiovascular parameter control by withdrawing the shunt into the superior cava vein and removing the remnant portion of the distal catheter (with a knot) by interventional snaring. Cardiac and vascular surgeons were on standby. The management of an ICMVP is complex and carries a high risk for severe potential complications. Two different pathophysiological mechanisms have been discussed in the literature, including gradual erosion into an adjacent vein and transvenous catheter placement of the initial shunt secondary to subcostal placement of shunt tunneling instruments. The suction effect of the venous system results in gradual pulling of the catheter into the venous system. [ABSTRACT FROM AUTHOR]

Objective To improve the confidence of the final year dental students in completing occlusal and oral rehabilitation of patients, with complexities beyond their scope, based on full analysis of the biomechanical and esthetic considerations of each case. Material & methods Two comprehensive patient situations presenting with special difficulties including extensive, reduced vertical dimension of occlusion, limited interocclusal space and maxillary alveolar bone for implant insertion necessitating bone augmentation and a sinus lift surgery was managed by two students at our institute. Procedures like surgical crown lengthening, sinus lifting, and bone augmentation were performed by senior faculty with the respective two students’ assisting as well as following up at the healing phase and reporting progress of healing and any possible complications to the supervisor. Students’ reported significant improvement in decision making skills; time management; interpersonal skills, management of cases in an evidence –based interdisciplinary approach as well as increase in their confidence in managing complex cases independently. Follow up with both cases showed optimum outcome and patients’ satisfaction. Results Students’ reported significant improvement in decision making skills; time management; interpersonal skills, management of cases in an evidence –based interdisciplinary approach as well as increase in their confidence in managing complex cases independently. Follow up with both cases showed optimum outcome and patients’ satisfaction. Conclusions Exposing students to manage complex oral rehabilitation including procedures like sinus lifting and bone augmentation, through an evidence-based interdisciplinary approach during the undergraduate comprehensive clinical dentistry course enhances their confidence and clinical acumen as an independent practitioner. [ABSTRACT FROM AUTHOR]

Due to the high incidence of sports concussion, various health and medical providers are likely to encounter athletes who have sustained such an injury. Management of concussion necessitates coordinated care by the members of the sports medicine team due to its pathophysiology and complexity of management during recovery. All members of the sports medicine team must possess contemporary knowledge of concussion management as well as strong interprofessional communication skills to ensure effective care and safe return to sports participation. Therefore, the aim of this manuscript is to review the current best practices in interdisciplinary management of sports concussion with a special emphasis on the required interprofessional communication among the sports medicine team. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Ortopédica y Traumatologia (English Edition) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The management of odontogenic infections is a typical part of the spectrum of maxillofacial surgery. Normally these infections can be managed in a straight forward way however under certain conditions severe and complicated courses can arise which require interdisciplinary treatment including intensive care. A retrospective analysis of all patients affected by an odontogenic infection that received surgical therapy from 2004 to 2011 under stationary conditions was performed. Surgical treatment consisted in incision and drainage of the abscess supported by additional i.v. antibiotic medication in all patients. Detailed analysis of all patients that required postoperative intensive medical care was additionally performed with respect to special risk factors. During 8 years 814 patients affected by odontogenic infections received surgical treatment under stationary conditions representing 4% of all patients that have been treated during that period ( n = 18981). In 14 patients (1.7%) intensive medical therapy after surgery was required, one lethal outcome was documented (0.12%). In all of these 14 patients a history of typical risk factors was present. According to these results two patients per week affected by an odontogenic infection required stationary surgical treatment, about two patients per year were likely to require additional intensive medical care. If well-known risk factors are present in patients affected by odontogenic infection appropriate interdisciplinary management should be considered as early as possible. [ABSTRACT FROM AUTHOR]

[Sterling M (2014) Physiotherapy management of whiplash-associated disorders (WAD). Journal of Physiotherapy 60: 5–12] [ABSTRACT FROM AUTHOR]

Until the 1980s, the primary goal of coastal works projects was to ensure safety at any cost. This was addressed in an essentially physical manner. Today, concerns are no longer limited to safety; lifestyle and quality of life have become essential components in the successful construction of coastal infrastructure. Other aspects of development have also become important, such as environmental impact, attractiveness and sustainability. New social realities must be addressed, as must the voices of actors and interest groups. The synthesis of recent concerns over coastal public works projects has become increasingly difficult due to new assumptions of value, social acceptance and the sustainability of these projects. In this context, it is now common knowledge that decision-making on a coastal issue should be based on multiple criteria, including technical effectiveness, costs, benefits, implementation and monitoring. Here, coastal issues are reviewed using the dual perspective of meeting current needs and ensuring future sustainability. It is shown that multifunctional facilities built near the coast are one viable solution for managing coastal erosion. The results of a case study conducted in a sensitive area of the Portuguese coast are also presented. Based on an exhaustive review of the literature, it is also shown that improving nautical sports and generating renewable energy should not be neglected. Finally, contemporary adaptation measures and future accommodation options are recommended. Unlabelled Image • Traditional and contemporary decision-making processes on coastal issues are reviewed. • Local communities and stakeholders should be engaged in decision-making processes. • Basic concepts to support shared and responsible coastal management are explored. • Coastal works with multifunctional purposes are discussed. • Accommodations to cope with coastal risks and climate change are needed. [ABSTRACT FROM AUTHOR]