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Ivabradine: A possible Restorative for Children Along with Refractory SVT.
When an orientee is struggling, early identification and intervention is key. ZEN-3694 research buy Implementing an action-learning plan refocuses the orientee, placing the accountability on them, targeting specific areas that will develop them as a competent nurse. The action-learning plan factors in holistic measures that help the orientee in processing their experience. The action-learning plan can be individualized to any unit and organization.A multimodal nursing pedagogy utilizing simulation was incorporated into annual nurse competencies at a 465-bed academic medical center to translate into practice the required surveillance of a potentially septic patient and the necessary clinical decision-making. Pretest/posttest was used to determine knowledge retention from simulation. Nurses' sepsis knowledge following simulation was improved. Simulation can provide long-term knowledge retention of sepsis for application into clinical practice and be a viable option for competency assessment for professional nurses.The purpose of this study was to investigate the impact that daily discharge education "bursts" using the teach-back method had on participants' confidence levels in their self-care management abilities. Daily educational bursts positively impacted participants' self-confidence in their postdischarge self-care management abilities. Nursing professional development practitioners could use the results of this study to address the inconsistency of providing effective, daily discharge education for patients.The transition from student nurse to nurse graduate can be overwhelming. Although nurse residency programs ease this transition, standardized patient (SP) simulations supplementing these programs are underutilized. An SP simulation series was created and imbedded into a behavioral health nurse residency program. Nurse residents were satisfied with the learning experience and gained self-confidence, which was sustained over 30 days. Staff development educators should consider supplementing a nurse residency program with an SP simulation to hone behavioral health clinical skill application.Primary ovarian carcinoid tumors are uncommon neoplasms that typically arise in the context of a mature cystic teratoma. Pure primary ovarian carcinoid tumors (PPOCTs) are rare and present as a solid ovarian mass in which, by definition, elements of an associated teratoma or other neoplasm are absent. We report a case of a middle-aged woman who presented with abdominal distension. Computed tomography identified a 20 cm abdominopelvic mass. The patient underwent exploratory laparotomy, hysterectomy, and bilateral salpingo-oophorectomy. A large, solid, yellow-tan ovarian mass was resected and diagnosed as a PPOCT. Para-aortic lymph node metastases were identified. This case highlights the gross and microscopic findings characteristic of PPOCTs. In addition, the large number of differential considerations for an insular PPOCT at intraoperative evaluation are discussed.Up to 2% of pregnant women develop a disease that requires nonobstetrical operative intervention during pregnancy. We discuss the issues unique to pregnant patients as they pertain to the presentation, diagnosis, and management of nonobstetric surgical disease, with an emphasis on 2 of the most common diseases that affect pregnant women appendicitis and cholecystitis. Surgery has been demonstrated to be safe and effective during pregnancy, provided proper precautions are taken into account. It is the consensus of multiple professional committees and societies that no pregnant women should be delayed or denied a necessary surgery because of pregnancy.STUDY DESIGN A mechanism-based reasoning and case-control study. OBJECTIVE To introduce correction target of clivo-axial angle (CXA) in quantitative surgical reduction of basilar invagination (BI). SUMMARY OF BACKGROUND DATA The exact mechanism of BI with or without atlantoaxial dislocation is still unclear. Sagittal deformity is a key feature of BI. Correction of CXA directly influences subaxial cervical lordosis (increase of CXA equals the decrease of cervical lordosis). However, a quantitative reference for correction surgery has not been established. MATERIALS AND METHODS CXA was divided by Chamberlain line into clivus tilt (CT) and axial tilt (AT). Patients diagnosed with BI were retrospectively included. Patients with degenerative cervical spine diseases or vascular diseases (without BI) were included as controls. CT, AT, and other common parameters were measured and analyzed with t test and multiple linear regression. Demonstration case was presented. RESULTS A total of 42 BI patients and 23 controls were included. Normal references for CXA, AT, and CT were 162.3±7.1, 93.8±6.5, and 68.6±3.8 degrees, respectively. BI patients had a 30.3-degree smaller CXA, a 15.5-degree smaller AT, and a 14.9-degree smaller CT. Basal angle (P=0.002) independently had a significant influence on extent of BI, while CT and AT did not. Demonstration case showed that CT was fixed and correcting AT to an ideal 94 degrees was optimal for an individual patient. CONCLUSIONS Proper quantitative correction of CXA needs to be individualized in consideration of CT and AT. The difference between actual AT and its ideal value (about 94 degrees) is the optimal target of CXA correction to decompress neural elements ventrally and recover better subaxial cervical lordosis. LEVEL OF EVIDENCE Level IV.STUDY DESIGN A prospective cohort. OBJECTIVE The objective of this study was to develop a scoring system for lumbar degenerative spondylolisthesis (LDS) that would guide decision-making. BACKGROUND The management protocol for LDS has been under debate, with no guidelines. Most studies oversimplify LDS as a homogenous entity. MATERIALS AND METHODS A retrospective analysis of 131 patients who underwent surgery for LDS between July 2007 and October 2011 with a minimum follow-up of 3 years was carried out on the basis of clinical, radiologic, and technical factors. A scoring system was conceptualized. Clinical back pain score-2, age younger than 70 years-1, high-demand activity-1. Radiologic segmental kyphosis-1.5, segmental dynamic translation-1, disk height >50% of adjacent level-1, facet effusion-1, sagittal facet-orientation-1. Technical feasibility to decompress without causing instability-1.5. Its reliability was ascertained by a univariate analysis. The benchmark was set at 5.5 according to the Youden Index.
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