Perioperative management of anticoagulants requires one to balance the patient's risk factors for operative bleeding, the type of operation to be performed, and the patient's risk of thromboembolism. At present, no set algorithm exists for the perioperative management of all the anticoagulants. In this article, we address the perioperative management of ...

This is the first in a set of documents intended to standardize techniques, procedures, and practices in the field of endovascular surgical neuroradiology. Standards are meant to define core practices for peer review, comparison, and improvement. Standards and guidelines also form the basic dialogue, reporting, and recommendations for ongoing practices ...

Surgical attire is intended to protect both patients and perioperative personnel. AORN published the "Recommended practices for surgical attire" to guide perioperative RNs in establishing protocols for selecting, wearing, and laundering surgical attire. Perioperative RNs should work with vendors and managers to ensure appropriate surgical attire is available, model the ...

Juvenile idiopathic arthritis (JIA)-associated uveitis can be associated with vision-compromising complications such as cataracts, glaucoma, synechiae, and band keratopathy. Of these, cataracts are one of the most common sequelae of JIA-associated uveitis and can result in significant visual disability. Risk factors for cataracts include posterior synechiae and longstanding ocular inflammation. ...

Skull base meningiomas represent the paradigm for the evolution of skull base surgery within the past 50 years into a distinct neurosurgical subspecialty. The evolution of surgical approaches to skull base meningiomas is reviewed, together with the current issues regarding radiation therapy, management of cavernous sinus tumor, oncologic management of ...

New graduates entering thoracic surgery often face bureaucratic barriers to beginning practice. It is important to understand the credentialing and privileging process to navigate these obstacles successfully. In addition, the implementation of cutting-edge technology by recent trainees can pose problems in institutions not familiar with newer surgical techniques. Efficient coding ...

With the increasing use of oral anticoagulation therapy the appropriate management of perioperative anticoagulation is of surgical importance. There is a delicate balance between the risk of a perioperative thromboembolic event and the risk of operative bleeding from anticoagulation. Whilst there are a range of options available to the clinician, ...

Intrusive luxation is the most common trauma during early infancy which results in the displacement of the tooth into its alveolus. Depending on the severity of the intrusion, the American Academy of Pediatric Dentistry recommends either extraction or spontaneous re-eruption for the primary tooth. This case report provides a brief ...

Bariatric and metabolic surgery is experiencing a noteworthy increase worldwide in recent years, but protocols and consensus published in the past decade have not yet established clear evidence-based clinical recommendations. The Endocrine Society, with the participation of the European Society of Endocrinology, has promoted the creation of an expert panel ...

BACKGROUND Melanoma is a life-threatening malignancy. Surgery is the primary management for melanoma, and management guidelines have evolved gradually over a century from radical surgery with lymph node dissection to conservative margin surgery. There are specific rationales and problems with Mohs micrographic (MMS) surgery for managing melanoma. OBJECTIVE To review ...

Alisdair MacIntyre argues that the virtues necessary for good work are everywhere and always embodied by particular communities of practice. As a general surgeon, MacIntyre's work has deeply influenced my own understanding of the practice of good surgery. The task of this essay is to describe how the guild of ...

Background: recent NICE guidance suggests primary surgery should be offered to patients presenting with glaucoma with severe visual field loss. We undertook a national survey of UK consultant ophthalmologists to determine if this approach reflects current practice. Design: Prospective questionnaire study. Participants: All consultant ophthalmologists currently practicing in the UK ...

There are significant workforce shortages for psychologists with expertise in evidence-supported therapies with children, particularly in nonmetropolitan areas. Telepsychology, or psychology services delivered by real-time videoconferencing, helps bridge this access gap. This article first reviews the telepsychology literature and then builds on early telepsychology guidance for the current practice environment. ...

Objective: Over the last 50 years, there has been a surge of interest by both the public and medical practitioners in therapies and disciplines that are not considered part of mainstream medical care. The title given to these is complementary and alternative medicine. Of all these branches, our interest is ...

Background and Purpose: Intermittent distance exotropia is difficult to conservatively manage, with techniques varying widely between institutions. This review aims to examine current literature on conservative management for intermittent distance exotropia, investigate its impact upon current clinical practice, and identify areas for further research. Method: A literature search was performed ...

Alcohol has long been used as a daily beverage in China and around the world. It is a medicinal substance with various biological activities. In fact, alcohol has played an important role in the development of traditional Chinese medicine (TCM), within which it is considered as the earliest exhilarant and ...

Vertical ocular motility disorders of supranuclear origin can be congenital or acquired later in life. They produce complex forms of strabismus that require specialized surgical management to restore ocular alignment, eliminate torticollis, treat diplopia, and restore normal lid position. For each condition, surgical management must be individualized to address multiple ...

Postoperative nausea and vomiting (PONV) are still common following surgery. This is not only distressing to the patient, but increases costs. The thorough understanding of the mechanism of nausea and vomiting and a careful assessment of risk factors provide a rationale for appropriate management of PONV. Strategy to reduce baseline ...

The search for generalities in ecology has often been thwarted by contingency and ecological complexity that limit the development of predictive rules. We present a set of concepts that we believe succinctly expresses some of the fundamental ideas in conservation biology. (1) Successful conservation management requires explicit goals and objectives. ...

doi: 10.1111/j.1741-2358.2010.00398.x Denture related stomatitis managed with tissue conditioner and hard autopolymerising reline material. Objective:  To compare the response of denture-related stomatitis (DS) under management with a tissue conditioner (TC) and autopolymerising hard reline material (AHRM). Background data:  Denture-related stomatitis affects up to 75% of denture wearers; not wearing the ...

Temporomandibular disorders can arise apparently idiopathically, as a result of macro-trauma or micro-trauma such as parafunction, as a result of a separate disease process or as a consequence of dental treatment. The objectives of this chapter are to make the practitioner aware of his/her responsibilities in any of these situations. ...

Prayer is the most common complementary and alternative intervention used by most Americans. Yet, little is known about the prayer practices of young adults. In this exploratory study, 4 types of prayer practices of 62 young adults (21-30 years old) are described. The 4 different categories of prayer were: contemplative-meditative, ...

External orthoses are used in the management of a variety of spinal disorders. Many types of brace are available to support the cervical, thoracic, and lumbar spine as well as junctional regions, which have special mechanical considerations. Many prefabricated and custom-made devices are available, made by a variety of manufacturers ...

This article discusses some of the practices of psychosocial treatment. Broadly speaking, these practices include an emphasis on the doctor-patient relationship, the creation of a sound and lasting alliance, and the experience of trust and partnership that the physician fosters in helping the patient to negotiate the complex and uniquely ...

People who administer organizations of various types, including medical practices, are finding it increasingly necessary to demonstrate leadership. The challenge is to understand the meaning of effective leadership and to have guiding principles with regard to its implementation. It is argued here that responsibility represents a key guiding theme that ...

Synthetic organic reactions are a fundamental enabler of small-molecule drug discovery, and the vast majority of medicinal chemists are initially trained--either at universities or within industry--as synthetic organic chemists. The sheer breadth of synthetic methodology available to the medicinal chemist represents an almost endless source of innovation. But what reactions ...

As more and more organizations with responsibility for natural resource management adopt adaptive management as the rubric in which they wish to operate, it becomes increasingly important to consider the sources of uncertainty inherent in their endeavors. Without recognizing that uncertainty originates both in the natural world and in human ...

Zoos and aquariums exhibit many rare species, but sustain few for long periods. Demanding genetic, demographic, and behavioral requirements are a part of the sustainability challenge, and historical zoo goals and limiting animal management objectives are another, but they have been overtaken by worldwide wildlife population contraction and endangerment. New ...

Pleural effusions are commonly encountered in clinical medicine. They can represent both a diagnostic and a therapeutic challenge. This article discusses the diagnostic modalities used to evaluate the patient with a pleural effusion. Also discussed are the therapeutic options for the 2 most common causes of pleural effusions encountered by ...

The assessment and management of dementia is complex. General practitioners are often the first point of contact for people with dementia, and their families. General practitioners have a key role in providing quality primary care in terms of the identification, assessment, provision of information, referral and ongoing management. This article ...

This review aims to provide guidance in managing glaucoma patients more effectively. It focuses on the importance of detecting progression and measuring its rate within the management of primary open-angle glaucoma today. Recent findings strongly indicate that continued monitoring of visual fields (VFs) and reassessment of target intraocular pressures (IOPs) ...

After the patents of biopharmaceuticals have expired, based on specific regulatory approval pathways copied products ("biosimilars" or "follow-on biologics") have been launched in the EU. This article summarizes experiences with hematopoietic medicines, namely the epoetins (two biosimilars traded under five different brand names) and the filgrastims (two biosimilars, six brand ...

The fields of tissue engineering (TE) and regenerative medicine (RegMed) are yet to bring about the anticipated therapeutic revolution. After two decades of extremely high expectations and often disappointing returns both in the medical as well as in the financial arena, this scientific field reflects the sense of a new ...

External ventricular drain (EVD) placement is standard of care in the management of aneurysmal subarachnoid haemorrhage-associated hydrocephalus (aSAH). However, there are no guidelines for EVD placement and management after aSAH. Optimal EVD insertion conditions, techniques to reduce the risk of EVD-associated infection and aneurysmal rebleeding, and methods of EVD removal ...

The use of botulinum toxin (BoNT) has now become the treatment of choice for a range of debilitating neuromuscular diseases and for aesthetic medicine. BoNT products are licensed as prescription-only medicines by the health authorities of each country in which they are approved. The authors describe here the current status ...

Illegal and unsustainable trade in wildlife is a major conservation challenge. For Asian primates, economic and cultural traditions, and increased forest access mean that trade may have become detrimental for certain species. Slow and slender lorises (Nycticebus and Loris) are primates particularly prevalent in trade, determined until now by focused ...

With practice bottom lines rapidly eroding, repeated threats of Medicare cuts, and the need to purchase expensive technology to meet the requirements of the American Recovery and Reinvestment Act, today's practicing physicians have no choice but to aggressively manage their revenue cycles. Physicians need to be paid in a timely ...

Zotero is a powerful free personal bibliographic manager (PBM) for writers. Use of a PBM allows the writer to focus on content, rather than the tedious details of formatting citations and references. Zotero 2.0 (http://www.zotero.org) has new features including the ability to synchronize citations with the off-site Zotero server and ...

OBJECTIVES: New and expensive medicines are a driving force behind growth in medicine costs, and policies promoting use of less expensive products have been widely introduced. This study investigated the short-term consequences of the restricted reimbursement of expensive statins (atorvastatin and rosuvastatin) on the use of statins in Finland. METHODS: ...

The moral perspective of justice proposes that when confronted by another person's mistreatment, third parties can experience a deontic response, that is, an evolutionary-based emotional reaction that motivates them to engage in retribution toward the transgressor. In this article, we tested whether the third party's deontic reaction is less strong ...

The reciprocal interactions with others that play such a significant part in our lives depend upon trust; individuals need to be confident that their partners are cooperative, and that they will return favours. Reputation permits the choice of better partners and provides incentives to be more cooperative. These uses of ...

PURPOSE OF REVIEW: Cultural practices that present with dermatologic manifestations in the pediatric population are common. However, such skin manifestations are often poorly understood in western medicine and lesions are misdiagnosed, with child abuse being a common misdiagnosis. RECENT FINDINGS: The 2000 Census counted approximately 28 million first-generation immigrants in ...

Endocrinopathic laminitis in horses and ponies has the potential to cause extensive damage to the feet before clinical signs of laminitis are apparent. Early diagnosis and intervention based on the detection and control of hyperinsulinemia are critical if the crippling changes that are seen in the disease are to be ...

Integrated coastal zone management (ICZM) addresses the interconnections, complexities, and conflicts between many users of the coastal area with different goals. It requires setting managerial boundaries that capture many elements of human and natural systems. Experience teaches us that without a directed effort managerial rules and laws are not likely ...

Coral reef fisheries are critical for food security and as a source of income in developing and developed countries, but they are collapsing in many areas. Following the emergence and routine availability of commercial very high spatial resolution (0.6-10 m) multispectral satellite images, we reviewed the use of these new ...

The enormously profitable complementary medicines, dietary supplements and traditional medicines markets are largely unregulated internationally and South Africa. Attempts to ensure that consumers are not exposed to harmful or ineffective products have met with varying success around the world.

This paper introduces a number of concepts that will recur throughout the series. It examines firstly the rationale behind what triggers patients' complaints and explores the concepts of precipitating and predisposing factors. If patients are dissatisfied they may seek legal redress and clinical negligence is explained briefly with an explanation ...

IMPORTANCE OF THE FIELD: Expiration of patents covering biopharmaceuticals, has provided opportunities for pharmaceutical companies to develop, produce and market biosimilars or follow-on biologicals. However, there have been concerns over the degree of similarity of these complex drugs in addition to the hope that their introduction may lower the cost ...

Obstetric cases are normally well managed on the labour suite. However, emergencies are not uncommon, and when they occur, they can be major. It is vital that rapid assessment and management are put in place. Critical care doctors are often called upon to do so.

Since 1996, genetically modified herbicide-resistant (HR) crops, particularly glyphosate-resistant (GR) crops, have transformed the tactics that corn, soybean, and cotton growers use to manage weeds. The use of GR crops continues to grow, but weeds are adapting to the common practice of using only glyphosate to control weeds. Growers using ...