Nashville TN 37232
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License #: MD29457
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Late-onset renal vein thrombosis: A case report and review of the literature. - International journal of surgery case reports
Renal vein thrombosis, a rare complication of renal transplantation, often causes graft loss. Diagnosis includes ultrasound with Doppler, and it is often treated with anticoagulation or mechanical thrombectomy. Success is improved with early diagnosis and institution of treatment.We report here the case of a 29 year-old female with sudden development of very late-onset renal vein thrombosis after simultaneous kidney pancreas transplant. This resolved initially with thrombectomy, stenting and anticoagulation, but thrombosis recurred, necessitating operative intervention. Intraoperatively the renal vein was discovered to be compressed by a large ovarian cyst.Compression of the renal vein by a lymphocele or hematoma is a known cause of thrombosis, but this is the first documented case of compression and thrombosis due to an ovarian cyst.Early detection and treatment of renal vein thrombosis is paramount to restoring renal allograft function. Any woman of childbearing age may have thrombosis due to compression by an ovarian cyst, and screening for this possibility may improve long-term graft function in this population.Published by Elsevier Ltd.
Increasing access to oral health care for people living with HIV/AIDS in rural Oregon. - Public health reports (Washington, D.C. : 1974)
Access to oral health care for people living with HIV/AIDS is a severe problem. This article describes the design and impact of an Innovations in Oral Health Care Initiative program, funded through the Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance (SPNS) program, that expanded oral health-care services for these individuals in rural Oregon. From April 2007 to August 2010, 473 patients received dental care (exceeding the target goal of 410 patients) and 153 dental hygiene students were trained to deliver oral health care to HIV-positive patients. The proportion of patients receiving oral health care increased from 10% to 65%, while the no-show rate declined from 40% to 10%. Key implementation components were leveraging SPNS funding and services to create an integrated delivery system, collaborations that resulted in improved service delivery systems, using dental hygiene students to deliver oral health care, enhanced care coordination through the services of a dental case manager, and program capacity to adjust to unanticipated needs.
The association between the social and communication elements of autism, and repetitive/restrictive behaviours and activities: a review of the literature. - Research in developmental disabilities
Research continues to try and pinpoint the etiological role of particular genes and brain structure in autistic spectrum disorder (ASD), but despite a host of biological, genetic and neuropsychological research, the symptom profile of pervasive developmental disorders (PDDs) are not yet linked to etiological theory. Debate continues around whether or not there is one single dimension that incorporates the three criteria domains of social difficulties, communication deficits and repetitive or restrictive interests and behaviours as a unitary 'ASD' concept, or whether PDD as they are currently described represent the co-occurrence of separate sub-domains of developmental difficulties. Although the three criteria need to be met for a diagnosis of PDD to be made, the association between them remains unclear. This review highlights that the majority of the literature that looks at the triad of impairments suggests the symptom structure does not match that proposed by diagnostic manuals, and that the triad may no longer fit as the best way to conceptualize ASD.Copyright Â© 2011 Elsevier Ltd. All rights reserved.
Patient safety considerations regarding dermal filler injections. - Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses
Today's population is seeking procedures that enhance or improve its appearance, that require little or no downtime, and that provide immediate results. Dermal filler injections are among the top five procedures performed for this purpose. Patient safety must remain the ultimate goal of any practitioner delivering such procedures. This column will examine pertinent safety considerations in relation to the delivery of dermal filler injections.
A factor analysis of the Wechsler Adult Intelligence Scale 3rd Edition (WAIS-III) in a low IQ sample. - The British journal of clinical psychology / the British Psychological Society
Previous factor analytic studies of the WAIS, WAIS-R and WAIS-III used standardization samples, (representing the general population), clinical populations (e.g. psychiatric) and 'non-clinical' groups (e.g. older adults). These studies endorsed the reliability of the scales in such samples and supported theoretical models of intelligence. The WAIS-III (1997) includes four Indexes based on factor analysis, which provide clinically useful information to practitioners, but have not been validated in a low IQ population. However, the WAIS-III is often administered to individuals with suspected or proven low IQ, as it offers service providers, legislators and the Department of Health with a reliable measure of IQ. The aim of this study was to investigate the factor structure of the WAIS-III in a low IQ sample.WAIS-III data was collected from assessments carried out in routine clinical practice from individuals with a full scale IQ of 74 or below (n=105). The data were subjected to factor analysis, using two types of factor analysis: principal axis factoring and principal components analysis. Orthogonal and oblique rotations were applied to the analyses.Only one robust solution could be extracted. This contained two factors, analogous to traditional verbal and performance sub-scales.This study does not support the four-factor solution which underlies WAIS-III index scores in a low IQ population.
Liver transplant recipients' first year of posttransplant recovery: a longitudinal study. - Progress in transplantation (Aliso Viejo, Calif.)
A longitudinal study of 20 liver transplant recipients was conducted to investigate their posttransplant recovery experience. Data were collected using semistructured interviews at 6 weeks, 6 months, and 1 year after transplantation. Qualitative analysis of data revealed physical, psychological, social, economic, and spiritual dimensions of recovery. Findings reflect ongoing improvement of physical health and functionality for most recipients. Those with continuing health problems often suffered from preexisting health conditions. Psychological adjustment was uneven, with intermittent periods of fear, anxiety, and depression. Some recipients reported short-lived split identities and personality changes. Social support of family was critical in the hospital and at home. Economic issues became primary by the 1-year interview, with all recipients questioning whether they could afford ongoing healthcare and medicines. Spiritual needs were met in secular and nonsecular activities. Findings suggest that healthcare personnel should attend to the lived experience of liver transplant recipients.
Father to father: focus groups of fathers of children with cancer. - Social work in health care
Caring for a child with cancer is a demanding experience for both parents, yet most research focuses on mothers. In this paper, we present the findings of a secondary analysis of data from a study in which the care-giving experience of fathers is investigated. In two focus groups, ten fathers provided first-hand information about caring for a child with cancer and its impact on their families. In addition, the findings demonstrate how these men through sharing a deeply meaningful and challenging experience offered mutual support and caring. This paper describes the fathers' remarkable and unexpected exchange. Social work implications are also addressed.
Renal cortical adenoma incidentally found during living donor nephrectomy. - Progress in transplantation (Aliso Viejo, Calif.)
We report a living related kidney donor incidentally found to have a renal cortical adenoma at nephrectomy. The patient is a 53-year-old man accepted for living related kidney donation. Predonation workup revealed a solitary left renal artery and, on the right kidney, a main artery with a small accessory artery in theupper pole. No other abnormalities were found in the medical history, physical examination, or laboratory and radiological studies. A left laparoscopic nephrectomy was planned. However, during dissection of the upper pole, a 5-mm mass was noted. The nephrectomy was completed, and the organ was preserved in cold University of Wisconsin solution. Permanent section histology showed that the lesion was mostly likely a renal cortical adenoma. As the risk of malignant transformation with immunosuppression could not be adequately determined, the kidney was not transplanted into the recipient. The donor elected not to have the kidney replaced, and the organ was discarded.
Father-to-father support: fathers of children with cancer share their experience. - Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses
Fathers are important to the stability of the family and to the coping of mothers and their children when there is a child in treatment with cancer. The vulnerability they experience is stupefying and causes self-doubt, general worry, and frustration with the medical care they receive. Fathers' experiences are relatively unreported in the literature, and even less so, the experiences of fathers with children who have cancer. This research is based on two focus groups of five men each who spoke unabashedly for more than 2 hours about their grief, their struggle to come to terms with the diagnosis and the role strain, and role confusion they experienced as fathers and husbands. The findings could be described as reflecting the following themes: (1) impact on the provider role, (2) the emotional impact: I cry privately, (3) it's the fight of our lives, (4) tag-team parenting, (5) hypervigilance, (6) that place is scary!, and (7) what happens next--coping and moving on. The group format was powerful in terms of what these men were willing to share of themselves and their experience. These groups could be characterized as the coming together of strangers, bound by the common experience of "cancer," who actively supported each other and each other's process. Implications for holistic nursing practice are provided.Copyright 2002 by Association of Pediatric Oncology Nurses
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