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The various presentations of osseous Langerhans cell histiocytosis (LCH) make it difficult to distinguish from other bone diseases. In addition, there is no universally accepted protocol for managing osseous LCH for single non-central nervous system-risk lesions. Here, the rare cases of two paediatric patients, aged 1 and 2 years, who presented with a solitary tibial lesion at time of LCH diagnosis, are reported. One patient progressed to multiple lesions after curettage of the original lesion. Subsequently, both patients received preventive chemotherapy using the Taiwan Paediatric Oncology Group (TPOG) revised protocol for treating low risk patients with LCH, namely, TPOG LCH2002-LR. After receiving this treatment, which included a schedule of prednisolone and vincristine for 6 weeks, followed by prednisolone, vincristine and 6-mercaptopurine for a further 48 weeks, both patients are free from recurrence or progression.Aortopulmonary window is a rare congenital heart disease that can increase pulmonary vascular resistance, exacerbate left-to-right shunt and lead to heart failure and respiratory tract infections. Most patients die during childhood. We report a 53-year-old male patient with a large aortopulmonary window combined with anomalous origin of the right pulmonary artery from the aorta, with Eisenmenger syndrome and without surgery.
Communication skills diminish with time and must be applied and updated frequently. Due to various professional constraints, the dentists may not be able to attend training programs to sharpen their skills. During patient interactions, dentists may face difficult situations which they may be unable to handle and, consequently, make them overreact. Therefore, there is a need to provide a platform to freely discuss their feelings, ideas, and take opinion from peers.
Training in communication skills customized for dealing with complete denture patients was conducted for the prosthodontic postgraduates. Based on feedback obtained, it was decided to have periodic meetings and the concept of
actice
riented-
eer
view for
rosthodontics (PrO-PReP) was introduced. This novel concept is a combination of the
elationship building, exploring
eactions, exploring
ontent, and
oaching (R2C2) model of residency education and the Balint method. The meetings were scheduled every one or two months based on the available caseload of the patients treated by the postgraduates.
The thematic analysis of the postgraduates' self-reflection during the sessions and the video recorded observations (assessed using the Kalamazoo scale) revealed that these sessions were effective in positively engaging the postgraduates to discuss their experiences, reflect on their performances, practice their newly gained skills, and learn from peer sharing.
The postgraduates felt that they have changed in their working style and were more confident to manage patients. They found such sessions very useful for being updated with the already-learned skills.
The postgraduates felt that they have changed in their working style and were more confident to manage patients. They found such sessions very useful for being updated with the already-learned skills.
Resilience training combined with medical system changes have the potential to reduce clinician burnout. We sought to estimate effects and assess feasibility of a brief gratitude intervention for primary care clinicians.
This was a pre-test/post-test single group intervention design with longitudinal follow-up. Volunteer participants were from either a primary care community engagement conference or worked at one of two clinical sites in a Western mid-size city. Eligible clinicians held an MD/DO or NP/PA degree and currently worked at least 0.50 FTE in a primary care clinical practice and were willing and able to participate in the initial group session and complete weekly journaling. The gratitude intervention consisted of an in-person 90-minute group psychoeducation and skills-building workshop, followed by an 8-week daily gratitude journal exercise. The primary outcomes were related to resilience, including coping self-efficacy, clinician autonomy, and self-care behaviors. The secondary outcomes were the feasibility and acceptability of the intervention, as well as career satisfaction, and types and frequency of things for which clinicians were grateful in their daily work.
The intervention was brief, feasible, and of interest to clinicians. Statistically significant improvements were seen in most outcome measures at both 4 and 8 weeks follow-up, with the exception of gratitude, which also increased, but not significantly so. Gratitude categories mentioned most frequently were support platforms at work (47%) and sense of competence (42%).
The intervention had positive effects on resilience and is a promising brief intervention for clinicians experiencing stress. Larger experimental designs are needed.
The intervention had positive effects on resilience and is a promising brief intervention for clinicians experiencing stress. Larger experimental designs are needed.Family planning is a basic national policy in China. An intrauterine device (IUD) is an important method of achieving family planning owing to its high safety, low cost, and convenient use. The indwelling birth control ring has no obvious adverse effects on the sexual life of women after the operation, and the process is reversible. read more This ring can be removed for women who want to have children again. There are approximately 100 million women with IUDs worldwide, with approximately 80 million in China. This finding accounts for approximately 40% of women of childbearing age in China. Although an IUD is safe, the invasive operation inevitably leads to complications, such as pelvic infection, abnormal menstruation, and damage to adjacent organs. Among them, ectopic bladder stone formation is a rare complication, but several related cases have been reported. We report four cases of heterotopia of an IUD and cystolithiasis, with diagnosis based on the medical history, clinical manifestations, imaging, and cystoscopic findings.
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