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Patient's Desires (patient + desire)
Selected AbstractsImprovement in arm and post-partum abdominal and flank subcutaneous fat deposits and skin laxity using a bipolar radiofrequency, infrared, vacuum and mechanical massage deviceLASERS IN SURGERY AND MEDICINE, Issue 10 2009Lori Brightman MD Abstract Background and Objectives Skin laxity of the body is a growing cosmetic concern. Laxity can result from chronological or photoaging and changes in body dimensions during pregnancy or weight loss. The end result is loose, sagging skin, and localized fat deposits. Liposuction and abdominoplasty or brachioplasty are established approaches to these issues. Patient desire for alternatives to surgical correction has spawned the development of non-invasive body contouring devices. The combination of infrared light (IR), bipolar radiofrequency (RF), vacuum and mechanical massage (Velashape, Syneron Medical Ltd, Israel) has demonstrated efficacy in improving skin appearance and circumference of the thighs [Goldberg et al., Derm Surg 2008; 34:204,209; Fisher et al., Derm Surg 2005; 31:1237,1241; Arnoczky and Aksan, J Am Acad Orthop Surg 2000; 8:305,313; Alster and Tanzi, J Cosmetic Laser Therapy 2005; 7:81,85; Wanitphakdeedecha and Manuskiatti, J Cosmet Dermatol 2006; 5:284,288; Nootheti et al., Lasers Surg Med 2006; 38: 908,912], but only anecdotal evidence has supported its use on other anatomic locations. This study was designed to evaluate the efficacy and safety of Velashape on additional body sites and more rigorously examine the technology's impact on upper arm as well as abdominal and flank circumference. Study Design and Methods Subjects were 28,70 years old, skin types I,V. Nineteen subjects underwent 5 weekly treatments of the upper arms, and 10 subjects underwent 4 weekly treatments of the abdomen and flanks. Treatments were performed using Velashape. Circumference measurements, photographs, and subject weights were performed prior to treatment and at 1- and 3-month follow-ups. Subjects were asked to record their treatment satisfaction level. Results Change in arm circumference, at the 5th treatment was statistically significant with a mean loss of 0.625,cm. At 1- and 3-month follow-ups, mean loss was 0.71 and 0.597,cm respectively. Reduction of abdominal circumference at 3rd treatment was statistically significant with a 1.25,cm mean loss. At 1- and 3-month follow-ups, average loss was 1.43 and 1.82,cm respectively. Conclusions This study demonstrates with statistical significance, sustainable reduction in circumference and improvement in appearance of arms and abdomen following treatment with Velashape. Lasers Surg. Med. 41:791,798, 2009. © 2009 Wiley-Liss, Inc. [source] Patients' Desire to Keep Their Babies in Their Rooms: What Does That Mean for Unit Staffing?JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 2010Professional Issues No abstract is available for this article. [source] Multidisciplinary treatment approach for crown fracture and crown-root fracture , a case reportDENTAL TRAUMATOLOGY, Issue 1 2007Wilson Roberto Poi Abstract,,, The increased incidence of traumatic injuries to anterior teeth is a consequence of leisure activities, where the most common injuries are crown fractures. Treatment of the dental trauma is complex and requires a comprehensive and accurate diagnostic and treatment plan. It is also important to consider the biological, functional, esthetic and economic aspects, as well as the patient's desire. The purpose of this article is to report a case that shows the multidisciplinary approach required to successfully manage the rehabilitation of a maxillary central incisor with a complex crown fracture and a maxillary lateral incisor, that at first presented an oblique crown-root fracture, and after the orthodontic extrusion, suffered a more apical new crown-root fracture. [source] Nontransplant Surgical Options for Congestive Heart FailureCONGESTIVE HEART FAILURE, Issue 1 2003Aftab R. Kherani MD A wide array of surgical options are currently available for the treatment of congestive heart failure ranging from traditional coronary artery bypass grafting to total artificial heart implantation. The indications for each procedure depend on the severity of disease and the individual patient's desires. Some surgical options are indicated for patients with moderate disease and prevent worsening heart failure, whereas other procedures are limited to patients who will only survive with high-risk surgery. Ongoing technologic advances are increasing the number of patients that benefit from the reparative surgical treatment of congestive heart failure. [source] Ethics Seminars: Withdrawal of Treatment in the Emergency Department,When and How?ACADEMIC EMERGENCY MEDICINE, Issue 12 2006Kelly Bookman MD Abstract Although increasing discussion has occurred within emergency medicine about indications for withholding cardiac life support and other resuscitative interventions, emergency physicians (EPs) may be less familiar with the ethical, legal, and practical issues surrounding withdrawal of life support that has already been initiated. Both physicians and out-of-hospital personnel must act rapidly in critical situations and must assume that the patient has the desire to be resuscitated, unless clear evidence exists to the contrary. Often, only after initial life-saving actions have stabilized the patient is there time to reflect and determine a patient's desires regarding such interventions. When the EP can clearly discern a patient's previously stated wishes during the emergency department (ED) stay, these wishes should be honored in the ED. Respecting a patient's request to avoid unwanted, invasive treatments near death may involve withdrawing interventions that could not be withheld during the first few minutes of care. In this article, the authors use a case of out-of-hospital stabilization of a patient as a springboard to review the ethical and legal framework for withdrawal of life-sustaining care, as well as the practical issues involved with withdrawal of such care in the ED. [source] Female Sexual Dysfunction in Urogenital Prolapse Surgery: Colposacropexy vs.THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2008Hysterocolposacropexy ABSTRACT Introduction., Colposacropexy (CSP), with or without hysterectomy, is a valid technique for the repair of severe urogenital prolapse. For many years, uterine prolapse has represented an indication for hysterectomy, apart from the presence or absence of uterine disease and the patient's desires. Nevertheless, sparing the uterus is essential to women not only to have normal sexual functioning but to maintain physical and anatomical integrity as well. Aim., To assess sexual function in a group of patients who underwent CSP or hysterocolposacropexy (HSP). Materials and Methods., We enrolled 37 patients who underwent surgery for urogenital prolapse (15 HSP, mean age 53 years; 22 CSP, mean age 56 years). Based on a preliminary sexual history and sexual questionnaire, all patients were sexually active before surgery. At a mean follow-up of 39 months, we reassessed the patients using the Female Sexual Function Index (FSFI). Main Outcome Measure., We considered sexual activity with a score of 30 = good, 23,29 = intermediate, and <23 = poor. Results., In patients who underwent CSP and HSP, sexual activity was good in 13% and 26%, intermediate in 33% and 21%, and poor in 54% and 53%, respectively; considering also five patients who no longer had sexual activity postoperatively. Nevertheless, the statistical analysis, performed based on the data obtained from the FSFI questionnaire, showed that there were no significant differences between the two groups of points in terms of total score,CSP 21.1 (1.2,33.5) vs. HSP 22.8 (3.6,34.5),and single domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) (P = not significant). Conclusions., Our data demonstrated no substantial differences regarding sexual activity in patients in which the uterus has been spared as opposed to those in whom it has been removed. Furthermore, in a small percentage of cases, surgery actually reduced regular sexual activity. Zucchi A, Costantini E, Mearini L, Fioretti F, Bini V, and Porena M. Female sexual dysfunction in urogenital prolapse surgery: Colposacropexy vs. hysterocolposacropexy. J Sex Med 2008;5:139,145. [source] Bed articles for nursing care , state of the art in two German hospitalsJOURNAL OF CLINICAL NURSING, Issue 3 2004Thomas Boggatz MA Background., Bed articles are basic instruments for positioning. Research about this topic has concentrated on evidence for better practice. However, little is known about what practitioners really do. Aims and objectives., This study intended to identify the most common bed articles used for positioning in two German hospitals, and to determine the decision-maker for their application and the purposes and criteria for their choice. Methods., Nursing experts from 100 wards were interviewed with the help of a structured questionnaire and based on these data a list of the 10 most frequent devices was compiled. Results., Supporting the body position was the most frequent intervention performed by German nurses, mainly with the help of hydraulic beds, pillows and blankets. Nurses were the main decision-makers for the use of these bed articles. Their choice was mainly based on work experience and patients' desires. Guidelines and literature played a minor role in this process. Relevance to clinical practice., If nurses, despite the medical doctors' role as the main decision-maker in German hospitals, exert significant influence on this aspect of care, they can support their position by evidence-based practice. [source] The Science of Communicating the Art of Esthetic Dentistry.JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 3 2000Part I: Patient-Dentist-Patient Communication ABSTRACT Many contemporary restorative procedures are primarily esthetically driven, and patients have high expectations. It is imperative for the restorative dentist to understand patients' desires and expectations prior to initiating irreversible therapy. It is equally important for patients to understand the anatomic and technical limitations inherent with restorative therapy. CLINICAL SIGNIFICANCE This article describes several relatively straightforward techniques that can assist in dentist-patient-dentist communication and allow the patient to visualize a reasonable facsimile of the definitive result prior to initiation of irreversible therapy. By using these techniques where indicated, the frustrating cycle of rejection and failure may be avoided. [source] | ||||||||||