An Engagement Intervention for Young Adults with Serious Mental Health Conditions.

Young adults with serious mental health conditions (SMHCs) often do not engage continuously with mental health services, and there are few engagement interventions designed for them. This qualitative study presents a blueprint for conceptualizing and developing an engagement intervention designed for young adults with SMHCs. The blueprint includes the following activities: (1) establishing a strong theoretical basis, (2) designing an initial manual based on previous research and practice, (3) systematically examining feedback on the manual from stakeholders, and (4) examining the feasibility, acceptability, and implementation demands of the intervention.

A new dimension: robotic reconstruction in plastic surgery.

Background: Robot-assisted surgery was first approved by the Federal Drug Administration in 1994. The robotic system has the advantages of three-dimensional visualization of the operating field, 7° range of motion, tremor elimination, 360°of freedom at 10-mm distance, and a comfortable, seated operating posture. The purpose of this paper is to present a new surgical tool, the robot, for use in reconstructive surgery.

Maximizing patient satisfaction and functional results after total knee arthroplasty.

The purpose of this article is to review the issues regarding preoperative patient expectations for total knee arthroplasty and whether or not these are fulfilled after surgery. The demographics of the typical total knee arthroplasty patient are changing, and the expectations regarding the outcome of the surgery have been changing as well. Patients are younger, heavier, more active, and often come to the surgeon's office with information provided via the Internet that may be inaccurate and/or misleading.

Overview of the treatment of acne vulgaris with topical retinoids.

Acne vulgaris is a common skin disease that is most effectively treated with a combination of topical products and, in some cases, systemic antibiotics. While it is important to treat papules, pustules, nodules, and cysts with topical or systemic antibiotics to suppress bacterial infection, all of these lesions develop from microcomedones. In fact, comedolytic agents enhance the effectiveness of antibiotics and limit the potential for recurrent acne lesions.

Epicardial Ablation of Supraventricular Tachycardia.

Epicardial catheter-based mapping and ablation of a variety of supraventricular tachycardias is feasible, safe, and effective. Supraventricular tachycardia substrates are not uncommonly epicardial, and approaches with percutaneous epicardial instrumentation or via the epicardial venous structures, such as the coronary sinus, are becoming more widely accepted. These techniques are an important treatment option as an alternative to a more invasive surgical approach or to allowing patients to suffer from an ongoing arrhythmia.

Rectal trauma and associated hemorrhage with the use of the ConvaTec Flexi-Seal fecal management system: report of 3 cases.

The management of fecal incontinence is a struggle to maintain patient hygiene and limit the transmission of nosocomial infections. Intrarectal devices that cause diversion and collection of the fecal stream have been used with increasing frequency. This method can effectively control patient waste if used in an appropriate setting.

Keloid treatment: is there a role for acellular human dermis (Alloderm)?

Background: Keloid management is faced with high recurrence rates. Keloid fibroblasts lack the normal negative feedback mechanism resulting in an exuberant scar formation. Alloderm doesn't undergo the same proliferative process as keloidal scar dermis.

Cecal volvulus in a multiple-gestation pregnancy.

Background: Intestinal obstruction during pregnancy is rare, with volvulus being responsible for about 25% of cases.

Case: We present a case in which a woman in the 12th week of a twin gestation presented with abdominal pain and distension. She was initially diagnosed with an ileus, and radiological studies at the time were deferred.

A unique case of ovarian psammocarcinoma with mediastinal, pulmonary, subcutaneous, and omental metastases.

Psammocarcinoma is a rare form of serous ovarian and peritoneal carcinoma, characterized by abundant psammoma bodies, invasiveness, and low-grade cytological features. Many of the cases which have been reported had extraovarian spread and peritoneal seeding at the time of presentation. We present a case of 45-year-old woman with ovarian psammocarcinoma who initially presented with a metastatic subcutaneous nodule, and was found to have pulmonary and mediastinal metastases.

Ischemic volvulus of the transverse colon: A case report and review of literature.

A 75-year old male presented to the emergency room with worsening abdominal pain and distension. Plain radiographs were suggestive of a large bowel obstruction due to volvulus. An attempt to detorse the volvulus and decompress the colon endoscopically failed, after which the patient was taken for an exploratory laparotomy.

Quadriceps muscle function in primary total knee arthroplasty.

Patient expectations after primary total knee arthroplasty (TKA) continue to increase as the arthroplasty population becomes younger. Patients desire more than just pain relief, function, and the ability to return to higher level activities after TKA. Quadriceps muscle function and strength are critical determinants of this outcome.

Hemipelvic amputations for recalcitrant pelvic osteomyelitis.

Objective: To evaluate the outcome of recalcitrant deep pelvic infection that required a hemipelvic amputation.

Study Design: Retrospective cohort.

Setting: Tertiary referral centre; Level I trauma.

Electronic medical records for the orthopaedic practice.

Electronic medical records (EMR) will be the standard method of medical documentation within the next decade. Making the conversion from paper to digital records will be costly in terms of actual cash outlay for an EMR system and the time investment in staff training, conversion of existing records and loss of operational efficiency during the implementation phase. The most difficult part of converting to EMR is ensuring the system you select will meet your practice's current objectives and those in years to come as technology--and the general population's adoption of it--changes.

Diagnosis of pneumothorax on F-18 FDG PET after transbronchial biopsy.

Transbronchial lung biopsy (TBLB) is associated with pneumothorax, 12% occurring 1 to 4 hours postprocedure (delayed pneumothorax). We report a case of a delayed pneumothorax first diagnosed on a positron emission tomography (PET) scan performed 5 days after TBLB. An early post-TBLB chest radiograph (after 1 hour) had not demonstrated any pneumothorax.

Gynecomastia: an outcome analysis.

Background: Gynecomastia refers to the presence of femalelike mammary glands in a male. This disorder can lead to significant psychologic stress and self-consciousness. This study consists of a chart review of 174 patients treated surgically between July 1, 1976, and February 27, 2001.

Use of the alexandrite laser for treatment of seborrheic keratoses.

Seborrheic karatoses are benign lesions that are easily irritated and often cosmetically objectionable. Liquid nitrogen cryotherapy and other surgical methods are useful in treating these lesions, but are difficult to tolerate in patients who have large numbers of lesions requiring treatment. The alexandrite laser was used in one patient to quickly and efficiently destroy hundreds of seborrheic keratoses.