Key Points on Short Term Medical Mission International organization on Orofacial cleft

Background: Children suffering from congenital facial malformations in underdeveloped countries are the main objective of the STMMIs with the aim of easing their lives. Clarós Foundation (CF) has carried out 115 missions worldwide with the aim, among others, of treating patients with this type of orofacial cleft malformation. We think that the experience we have acquired in this field can be transmitted to new NGOs institutions that want or wish to continue in this line. The optimization of the use of means and human resources, both from the NGO and the local health workers, will make it possible to achieve greater outcomes and results when applied in the development of Short Term Medical Mission International (STMMIs) missions. Material and Methods: We present the experience CF has acquired throughout the various STMMIs it has accomplished, during a period of 7 days each, specifying the details of its organization, patient selection, preparation of the surgery and its performance, in a well- organized manner to be fast, effective and safe in its results. During each of the 115 missions, the medical team has treated patients with this congenital pathology, in different proportions that go from 90% of the total cases to only 10% of the patients attended. The surgical techniques applied are those used in our medical center in Barcelona, which we may say, are the state-of-the-art surgical techniques used by the most advancedcenters. Results: A total of 1725 patientsunderwent surgery throughout 115 STMMIs, averageduration of 7 days each,115 STMMIs by 15 cases average. During this time 925 patients were operated for cleft lip and 800 patients for cleft palate. Male patients accounted for 58% and female for 42%. According to the age of the patients we found that the majority of cases were operated on babies 68.35% (1.179 neonatal period); 20.2% on children (300 cases) and (19.76%) adolescents (233 cases); and 1.10% adults in the 20-67 age range (13 cases). Of the total number of operated patients(1.725), there have been few immediate and late postoperative complications, but we estimate them at 11%. Conclusion: International cooperation between experienced NGOs and local medical teams turn out to be much more effective, less expensive and with better clinical results than those obtained without this collaboration. This organizational model can be very useful in order to know the details that these missions entail and apply them in your own activities.

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Open or arthroscopic Latarjet? Prospective analysis of the clinical results

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00004 ◽

2021 ◽

Vol 9 (2_suppl) ◽

pp. 2325967121S0000

Author(s):

Mathieu Girard ◽

Yoann Dalmas ◽

Vadim Azoulay ◽

Marie Martel ◽

Simon Rattier ◽

...

Keyword(s):

Surgical Techniques ◽

Clinical Results ◽

Bone Block ◽

Return To Sports ◽

Short Term ◽

Significant Difference ◽

Bone Block Procedure ◽

Group A ◽

Net Promoter

Objectives: The arthroscopic bone block procedure in the treatment of anterior shoulder instabilities is now a validated technique. Nevertheless, few studies have compared the clinical results of this technique to the conventional Latarjet procedure. Therefore the objective of this study was to compare the short-term clinical results of the 2 surgical techniques. Methods: We conducted a monocentric prospective comparative study, including patients who had undergone a bone block procedure for anterior instability with a minimum follow-up of 12 months. Patients with a surgical history concerning the affected shoulder were excluded. Evaluation was based on the measurement of mobility, the Walch-Duplay score, the Rowe score, the Subjective Shoulder Value (SSV), return to sports, the Net Promoter satisfaction Score, and recurrence (subluxation/luxation). Scarring was assessed by the POSAS score. Results: It was possible to follow 45 patients: arthroscopy (A) n=22, open (O) n=25. With an average follow-up of 20 months (12-30), no recurrence of instability was recorded. No significant difference was noted between groups A and O in terms of the Walch-Duplay score (85±19 vs 91±11 points; p=0.3), the Rowe score (93±14 vs 95±9 points; p=0.9), the SSV (72% vs 88%; p=0.2) and the Net Promoter Score (9.3 vs 9.7; p=0.5). At 3 months, return to sports was 11% for group A vs 48% for group O (p=0.01). This difference was no longer significant at 6 months. Loss of external rotation in group A was significantly greater at 1.5 months -58°±18° vs -41°±17° (p=0.01) and 3 months -35°±20° vs -19°±18° (p=0.01). There was no difference in the POSAS score between the 2 groups. (p= 0.9). Conclusion: With a longer recovery time for joint amplitudes and a delayed return to sports, the arthroscopic double-button fixation procedure does not seem to provide any short-term clinical benefit. Longer follow-up is required to confirm these results.

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Complex PCI after bypass grafts failure

Romanian Journal of Cardiology ◽

10.47803/rjc.2020.30.3.437 ◽

2020 ◽

Vol 30 (3) ◽

pp. 437-442

Author(s):

Radu Brezeanu ◽

Adrian Bucsa ◽

Gabriel Stanica ◽

Carmen Beladan ◽

Carmen Ginghina ◽

...

Keyword(s):

Artery Bypass ◽

Bypass Graft ◽

Surgical Techniques ◽

Clinical Results ◽

Intensive Care Treatment ◽

Artery Bypass Graft ◽

Challenging Problem ◽

Short Term ◽

Short Term Mortality ◽

Ischemic Events

The recurrence of ischemic events in patients with prior coronary artery bypass graft surgery (CABG) is an actual and challenging problem. Advances in surgical techniques and intensive care treatment have decreased the short-term mortality after CABG. Nevertheless, the increase in age and comorbidities of patients referred for CABG impacts the likelihood of graft degeneration or graft failure. More patients are referred to the cardiologist after CABG for the recurrence of symptoms. Particularities in the diagnosis and treatment of these patients need to be considered by the interventional cardiologist to ensure good angiographic and clinical results.

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Surgical Management of Osteochondral Lesions of the Talus

The Duke Orthopaedic Journal ◽

10.5005/jp-journals-10017-1054 ◽

2015 ◽

Vol 5 (1) ◽

pp. 35-47

Author(s):

Selene G Parekh ◽

Mark E Easley ◽

Samuel B Adams ◽

Christopher E Gross

Keyword(s):

United States ◽

Surgical Management ◽

Cartilage Repair ◽

Surgical Techniques ◽

Clinical Results ◽

The United States ◽

Osteochondral Lesions ◽

Scaffold Material ◽

Short Term ◽

Cell Source

ABSTRACT Osteochondral lesions of the talus (OLT) present a formidable treatment challenge to the orthopaedic surgeon. Historical cartilage repair strategies often result in the formation of fibro cartilage leading to suboptimal clinical results. With advances in regenerative medicine, modern surgical techniques are diverse and employ autograft, allograft and tissueengineered constructs for cartilage repair. Fresh and particulated juvenile allograft transplantation have become popular options in the United States. Worldwide, both cellular and acellular tissueengineered constructs are utilized. In all cases, there is still debate as to the optimal cell source and scaffold material and only short term clinical results are available. This article will review these current as well as experimental techniques for cartilage repair of osteochondral lesions of the talus. Adams Jr SB, Gross CE, Tainter DM, Easley ME, Parekh SG. Surgical Management of Osteochondral Lesions of the Talus. The Duke Orthop J 2015;5(1):3547.

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Extending the Vision of Short-Term Medical Teams

Journal of Doctoral Nursing Practice ◽

10.1891/2380-9418.10.2.144 ◽

2017 ◽

Vol 10 (2) ◽

pp. 144-148

Author(s):

Susan Burt

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Professionals ◽

Local Health ◽

Care Providers ◽

Coordinated Care ◽

Care Model ◽

Short Term ◽

Local Health Care ◽

Medical Teams

Short-term medical teams (STMTs), serving for a week or two, often do not partner with the local health care system. As a result, nationals receive poor care coordination and duplication of medical services (Green, Green, Scandlyn, & Kestler, 2009). This article offers a care model and collaboration alternatives to support coordinated care. Experience: An STMT composed of 15 health care professionals provided care at a local camp in rural Guatemala. The pre-trip preparation included securing supplies and communicating with another STMT that visits the camp each year. Results: The Guatemala medical team treated 494 patients and dispensed 989 medications. Despite communication with a previous STMT, possible duplication of services occurred with an absence of medical follow-up. Analysis: Evaluation of the STMT’s experience involved analyzing the number of people seen and medications dispensed, reflecting on conversations with local health care providers and patient. Discussion: The STMT’s goal was to provide care to people living in poverty. Unfortunately, team members learned that their unfamiliarity with the local medical system resulted in duplication of services. If sustainable care is to occur, future teams should use a care model and collaborate with the local health care professionals.

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Comparison of the short-term clinical results of silicone and acrylic intraocular lens in patients with diabetes mellitus

Korean Journal of Ophthalmology ◽

10.3341/kjo.2001.15.1.15 ◽

2001 ◽

Vol 15 (1) ◽

pp. 15 ◽

Cited By ~ 2

Author(s):

H K Choung ◽

J H Lee

Keyword(s):

Diabetes Mellitus ◽

Intraocular Lens ◽

Clinical Results ◽

Short Term ◽

Patients With Diabetes

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Increased stress, weight gain and less exercise in relation to glycemic control in people with type 1 and type 2 diabetes during the COVID-19 pandemic

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-002035 ◽

2021 ◽

Vol 9 (1) ◽

pp. e002035

Author(s):

Merel M Ruissen ◽

Hannah Regeer ◽

Cyril P Landstra ◽

Marielle Schroijen ◽

Ingrid Jazet ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Weight Gain ◽

Glycemic Control ◽

Perceived Stress ◽

Medical Center ◽

Short Term ◽

Design And Methods

IntroductionLockdown measures have a profound effect on many aspects of daily life relevant for diabetes self-management. We assessed whether lockdown measures, in the context of the COVID-19 pandemic, differentially affect perceived stress, body weight, exercise and related this to glycemic control in people with type 1 and type 2 diabetes.Research design and methodsWe performed a short-term observational cohort study at the Leiden University Medical Center. People with type 1 and type 2 diabetes ≥18 years were eligible to participate. Participants filled out online questionnaires, sent in blood for hemoglobin A1c (HbA1c) analysis and shared data of their flash or continuous glucose sensors. HbA1c during the lockdown was compared with the last known HbA1c before the lockdown.ResultsIn total, 435 people were included (type 1 diabetes n=280, type 2 diabetes n=155). An increase in perceived stress and anxiety, weight gain and less exercise was observed in both groups. There was improvement in glycemic control in the group with the highest HbA1c tertile (type 1 diabetes: −0.39% (−4.3 mmol/mol) (p<0.0001 and type 2 diabetes: −0.62% (−6.8 mmol/mol) (p=0.0036). Perceived stress was associated with difficulty with glycemic control (p<0.0001).ConclusionsAn increase in perceived stress and anxiety, weight gain and less exercise but no deterioration of glycemic control occurs in both people with relatively well-controlled type 1 and type 2 diabetes during short-term lockdown measures. As perceived stress showed to be associated with glycemic control, this provides opportunities for healthcare professionals to put more emphasis on psychological aspects during diabetes care consultations.

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Revisional Techniques for Secondary Cleft Lip Deformities

Seminars in Plastic Surgery ◽

10.1055/s-0041-1728673 ◽

2021 ◽

Vol 35 (02) ◽

pp. 065-071

Author(s):

Shayan M. Sarrami ◽

Anna J. Skochdopole ◽

Andrew M. Ferry ◽

Edward P. Buchanan ◽

Larry H. Hollier ◽

...

Keyword(s):

Minimally Invasive ◽

Early Life ◽

Cleft Lip ◽

Primary Repair ◽

Surgical Techniques ◽

Minimally Invasive Techniques ◽

Adjacent Tissue ◽

Tissue Transfer ◽

Invasive Techniques

AbstractSecondary deformities of repaired cleft lips are an unfortunate complication despite the meticulous approach of modern primary procedures. Most of these surgeries take place in the patient's early life and must be strategically planned to provide optimal cosmesis with minimal interventions. Depending on the level of severity, treatment of the secondary deformities ranges from noninvasive or minimally invasive techniques to complete revision cheiloplasty. Many novel topical, injectable, and laser therapies have allotted physicians more technical flexibility in treating superficial distortions. Nonetheless, surgical techniques such as diamond excision and adjacent tissue transfer remain popular and useful reconstructive modalities. Deformities involving the orbicularis oris must be completely taken down to allow full access to the muscle. Complete revision cheiloplasty requires recreation of the cleft defect and reconstruction similar to the primary repair. Due to the myriad of presentations of these secondary deformities, familiarity with the various treatments available is imperative for any cleft surgeon.

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Examining local perspectives on the influence of climate change on the health of Hamer pastoralists and their livestock in Ethiopia

Pastoralism Research Policy and Practice ◽

10.1186/s13570-021-00191-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Samuel Lumborg ◽

Samuel Tefera ◽

Barry Munslow ◽

Siobhan M. Mor

Keyword(s):

Climate Change ◽

Water Scarcity ◽

Health Workers ◽

Animal Health ◽

Disease Outbreaks ◽

Vulnerable Groups ◽

Local Health ◽

Framework Analysis ◽

Healthcare Facilities ◽

Grazing Lands

AbstractThis study explores the perceived influence of climate change on the health of Hamer pastoralists and their livestock in south-western Ethiopia. A combination of focus group discussions and key informant interviews were conducted with Hamer communities as well as local health workers, animal health workers and non-governmental organisation (NGO) staff. Thematic framework analysis was used to analyse the data. Reductions in rangeland, erratic rainfall, recurrent droughts and loss of seasonality were perceived to be the biggest climate challenges influencing the health and livelihoods of the Hamer. Communities were travelling greater distances to access sufficient grazing lands, and this was leading to livestock deaths and increases in ethnic violence. Reductions in suitable rangeland were also precipitating disease outbreaks in animals due to increased mixing of different herds. Negative health impacts in the community stemmed indirectly from decreases in livestock production, uncertain crop harvests and increased water scarcity. The remoteness of grazing lands has resulted in decreased availability of animal milk, contributing to malnutrition in vulnerable groups, including children. Water scarcity in the region has led to utilisation of unsafe water sources resulting in diarrhoeal illnesses. Further, seasonal shifts in climate-sensitive diseases such as malaria were also acknowledged. Poorly resourced healthcare facilities with limited accessibility combined with an absence of health education has amplified the community’s vulnerability to health challenges. The resilience and ambition for livelihood diversification amongst the Hamer was evident. The introduction of camels, increase in permanent settlements and new commercial ideas were transforming their livelihood strategies. However, the Hamer lack a voice to express their perspectives, challenges and ambitions. There needs to be collaborative dynamic dialogue between pastoral communities and the policy-makers to drive sustainable development in the area without compromising the values, traditions and knowledge of the pastoralists.

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Histologic Aspect of the Curved Vomerine Mucosa in Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211031419 ◽

2021 ◽

pp. 105566562110314

Author(s):

Benito K. Benitez ◽

Andrzej Brudnicki ◽

Prasad Nalabothu ◽

Jeannette A. von Jackowski ◽

Elisabeth Bruder ◽

...

Keyword(s):

Nasal Mucosa ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Squamous Metaplasia ◽

Periodic Acid ◽

Surgical Techniques ◽

Basal Cells ◽

Periodic Acid Schiff ◽

Tissue Samples ◽

Nasal Floor

Background: Common surgical techniques aim to turn the entire vomerine mucosa with vomer flaps either to the oral side or to the nasal side. The latter approach is widely performed due to the similarity in color to the nasal mucosa. However, we lack a histologic description of the curved vomerine mucosa in cleft lip and palate malformations. Methods: We histologically examined an excess of curved vomerine mucosa in 8 patients using hematoxylin–eosin, periodic acid–Schiff, Elastin van Gieson, and Alcian blue stains. Tissue samples were obtained during surgery at 8 months of age. Results: Our histological analysis of the mucoperiosteum overlying the curved vomer revealed characteristics consistent with those of an oral mucosa or a squamous metaplasia of the nasal mucosa, as exhibited by a stratified squamous epithelium containing numerous seromucous glands. Some areas showed a palisaded arrangement of the basal cells compatible with metaplasia of respiratory epithelium, but no goblet cells or respiratory cilia were identified. Abundant fibrosis and rich vascularity were present. Conclusion: The vomer mucosa showed no specific signs of nasal mucosa. These findings should be considered in presurgical cleft orthopedics and palatal surgery for further refinement. Shifting the vomer mucosa according to a fixed physiologic belief should not overrule other important aspects of cleft repair such as primary healing and establishing optimal form and function of palatal roof and nasal floor.

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