Laterally Based Island Pedicle Flap with Cheek Advancement for Defects of the Nasal Ala.

V-to-Y advancement flap is a successful repair technique that preserves vascular and tissue integrity adopted after Mohs micrographic surgery to repair cutaneous defects on the head and neck. However, defects at the lateral distal nasal ala requires large extension beyond cosmetic margins that increase risk of skin webbing, an undesired result on a cosmetically sensitive location to the patient. In this article, we present a novel approach to modifying the procedure employing the V-to-Y advancement flap by truncated the trailing end of the island pedicle to allow for successful healing and better patient satisfaction.

New and Emerging Topical Therapies for Psoriasis and Atopic Dermatitis.

Psoriasis and atopic dermatitis represent two of the most common skin conditions seen by both primary care and specialist dermatology. The prevalence of psoriasis in North America is 2 to 4 percent, and it is estimated to cost more than $3 billion per year to treat this condition. Atopic dermatitis has an estimated 15 to 30 percent lifetime prevalence in children and an 8 to 10 percent lifetime prevalence in adults.

Supporting Muslim Patients During Advanced Illness.

Religion is an important part of many patients' cultural perspectives and value systems that influence them during advanced illness and toward the end of life when they directly face mortality. Worldwide violence perpetrated by people identifying as Muslim has been a growing fear for people living in the US and elsewhere. This fear has further increased by the tense rhetoric heard from the recent US presidential campaign and the new presidential administration.

Termination: A Case Study.

In this article I posit and examine certain criteria and qualities for ending an analysis. The case study describes the end phase of a four-year psychoanalysis in which the patient's decision to move to another area forced the end of his analysis. We continued to explore and work through his core neurotic conflicts that included issues of competitive rivalry, dominance and submission, control, and anxiety about birth and death.

Cardiovascular disease in Sub-Saharan Africa: a complex picture demanding a multifaceted response.

A debate has emerged as to what should be the 'appropriate' cardiovascular agenda for sub-Saharan Africa. This Clinical Advance article reviews a recent study by Sliwa et al., which describes patients with newly diagnosed cardiovascular disease (CVD) presenting to a tertiary-care center in South Africa.

A family assessment tool for hospitalized elders.

This article describes the development of the FAMILY card, a family assessment instrument used in the Nursing Care Quality Initiative (NCQI) to assess the involvement and needs of family members of hospitalized elders. Through the NCQI project, particular attention has been paid to integrating both clinical expertise in geriatric nursing care and the principles of family-centered care into the nursing care provided by staff on the NCQI study units. Two case studies illustrating use of the SPICES geriatric assessment instrument and the newly developed FAMILY assessment card are included as exemplars.