Arildsenwelsh5039

The standard treatment approach for localised Merkel cell carcinoma (MCC) is wide surgical excision followed by adjuvant radiotherapy. However extensive surgery for locally advanced MCC may cause morbidity and disfigurement, compromise function and delay adjuvant therapy. Since MCC is a highly radiosensitive tumour, an alternative treatment option for advanced MCCs, especially those in anatomically challenging locations, is radiotherapy. Complete and durable control is achieved in up to 90% of cases if the definitive treatment of primary MCC is with radiotherapy. It is generally less morbid than surgery and can produce excellent cosmetic and functional outcomes.This study aimed to examine the relationships between subjective taste sensations and electrogustometry (EGM) findings in patients with taste disturbances according to the presence of burning mouth (BM) symptoms. Forty-six patients were included and asked to complete a questionnaire that contained questions on subjective taste sensations for the four basic taste qualities and the pattern of taste disorders such as ageusia, hypogeusia and dysgeusia. EGM was performed to measure detection thresholds. To examine the influence of BM symptoms, patients were divided into two groups patients with and without BM symptoms. The patients consisted of 11 men and 35 women. The group without BM symptoms (n=26) had significantly lower degrees of subjective taste sensations for all taste qualities and higher correlation levels between subjective taste sensations and EGM thresholds than the group with BM symptoms (n=20). The patterns of taste disorders also showed more significant associations with the levels of subjective taste sensations in the patients without BM symptoms compared with those with BM symptoms. In conclusion, patients with taste disorders without BM symptoms had more severe taste disturbances than those with BM symptoms. The pathophysiology of taste disturbances differs according to the presence or absence of BM symptoms.

Acute osteomyelitis of the distal fibula is a rare disease in children and is characterized by special features compared with other sites. The objective of this study was to report the functional outcome at long-term follow-up.

We reviewed retrospectively, between January 2000 and December 2010, all cases of acute osteomyelitis of the distal fibula. Epidemiological and bacteriological data as well as therapy and outcome factors were analyzed. At the last follow-up, functional outcome was studied based on ankle motion, growth disturbance, and radiological sequelae.

Seven cases of acute osteomyelitis of the distal fibula were found. The mean age was patients was 7.71 years and the sex ratio was 2.5. The portal of entry of the pathogen was a skin injury in 57% of cases. Staphylococcusaureus was identified in 71% of cases. The mean duration of antibiotic therapy was 33.2 days. At a mean of 12.85 years of follow-up, no growth disturbance was found. The mean plantar and dorsal flexion was 41° and 27.7°, respectively. The mean postoperative American Orthopedics Foot and Ankle score (AOFAS) was 96.71 points.

Acute osteomyelitis of the distal fibula in children is scarce and rarely reported in the literature. It occurs more often in boys at an average age of 7 years. Local symptoms are usually more obvious than general symptoms. Surgical debridement of the subperiosteal abscess without bone trepanation seems to lead to a satisfactory outcome.

Level IV-case series. IRB Sahloul Hospital Human Research Ethics Committee.

Level IV - case series. IRB Sahloul Hospital Human Research Ethics Committee.At the end of 2019, there was discussion in France about whether to abolish the obligatory medical certificate of no contraindication for a minor to obtain a sports license. It was finally decided not to abolish the certificate, but it raises the question of which steps should be taken to assess the physical capacities of children. General practitioners or pediatricians are responsible for the preparticipation physical evaluation of children wishing to obtain a sports license, in particular involving over 20 mandatory consultations between the ages of 0 and 18. The purpose of the article is to propose a course of action to be taken considering the French legislation and general pediatric resources concerning the medical examination and warning signs that should lead to vigilance.

A better understanding of the lawful use of guns and the symbolic meaning of guns to gun owners is essential to bridge the divide in public opinion regarding policies to reduce gun violence in the U.S.

A national, prerecruited Internet panel of U.S. selleck screening library adults in 2019 was used to survey gun owners (n=2,086) to ascertain their gun-related attitudes and practices. Data were analyzed in 2020.

The primary reason given for owning a gun was defense (59.4%), followed by recreation (26.8%). A minority of the gun owners in the sample (22.9%) reported taking part in any gun-related activity more than rarely. The proportion of respondents who agreed that guns are an important part of their identity was just 10.0%. The majority of the gun owners viewed gun control advocates as wanting to take away all guns (58.5%). Nearly 70% of gun owners reported that a reason for their reluctance to engage in gun violence prevention was that they feel alienated because they perceive gun control advocates as blaming them for the gun violence problem, not understanding gun ownership, and not understanding much about guns.

For most of the gun owners, gun ownership plays a practical role as a method of self-protection and has a symbolic association with freedom. Public health practitioners must develop novel communication strategies that avoid alienating gun owners by creating a perception that the ultimate aim is to take their guns away.

For most of the gun owners, gun ownership plays a practical role as a method of self-protection and has a symbolic association with freedom. Public health practitioners must develop novel communication strategies that avoid alienating gun owners by creating a perception that the ultimate aim is to take their guns away.

This study aimed to evaluate the implementation of nursing actions in anesthesia guided by the Patient Safety Checklist Nursing Anesthetic Procedure and the difficulties in performing patient care.

A cross-sectional study.

Nursing actions were evaluated in 282 anesthetic procedures of adult patients undergoing general anesthesia in three periods of anesthesia in a private hospital operating room in Brazil, from January to July 2018. The evaluated outcomes were the number of items performed by nurses during anesthesia periods and limitations for applying the Patient Safety Checklist Nursing Anesthetic Procedure instrument.

Execution of the nursing actions presented a mean percentage of 85.6, highlighting the anesthetic induction stage and differences between the periods before induction and reversal. The main items not performed in evaluating the nursing care in anesthesia were as follows the anesthesia equipment test (84; 29.78%) in the preinduction period; the evaluation of adequate ventilation (132; 46.81%) in the induction period; and the tracheal aspiration assistance (62; 21.98%) during reversal. Receiving a call from another room with care interruption was highlighted among the nurses' justifications for not performing the activities and difficulty in continuing care because of shift change.

The execution of nursing care actions in anesthesia mainly occurred during the period related to induction, with limitations because of dimensioning of operating rooms and simultaneous procedures.

The execution of nursing care actions in anesthesia mainly occurred during the period related to induction, with limitations because of dimensioning of operating rooms and simultaneous procedures.

With the increase of smartphone use and availability over the last decade, mobile healthcare applications have become more accessible. Many of these applications allow users to track behaviors and goals, and acquire feedback and information while on the go. Recent studies appearing in the literature suggest that smartphones may offer a means of augmenting clinical voice assessment by recording individuals with voice disorders outside the clinic for the purpose of extracting acoustic characteristics. This review examines the effectiveness of smartphones in clinical voice assessment and treatment, as reported in the current literature.

The PubMed database was searched using a combination and variation of different term related to smartphones, voice, and recording apps, in order to find articles that address the role of smartphones in clinical voice recording and assessment.

Six studies published in the last 3 years were reviewed and examined in terms of types of device and operating systems used, types of subjects and disorders studied, voice parameters extracted, and microphones used. Considerations such as impact of environmental noise, and privacy and security issues are also examined. While smartphones and mobile apps have the potential to be valuable tools in voice assessment outside the clinic, further efforts are needed for them to be effectively used in a clinical setting.

Six studies published in the last 3 years were reviewed and examined in terms of types of device and operating systems used, types of subjects and disorders studied, voice parameters extracted, and microphones used. Considerations such as impact of environmental noise, and privacy and security issues are also examined. While smartphones and mobile apps have the potential to be valuable tools in voice assessment outside the clinic, further efforts are needed for them to be effectively used in a clinical setting.At high altitude, low oxygen partial pressure predisposes human body to hypobaric hypoxia that may lead to high-altitude illness. Currently, singing had been used for rehabilitation of patients with lung diseases but its role in high-altitude low oxygen environment is still scarce. This study aims to examine the effect of singing in improving oxygen saturation at different levels of high altitudes in a hypobaric chamber. Eight healthy volunteers were assigned to three interventions at three simulated altitudes (sea level, 3000 m and 5000 m). The oxygen saturation (SpO2) was measured via pulse oximetry under three conditions no singing (NS), singing aloud (SA), and singing silently (SS). The "birthday song" was used as the standard song for 4 minutes. At sea level, mean NS SpO2 was 97.75% ± 1.04%. With SS, the level increased to 98.25% ± 1.04%. Mean SA SpO2 increased to 98.38% ± 0.92% (P less then 0.05). At 3000 m, mean NS SpO2 was 92.75% ± 3.73% and rose to 94.50% ± 2.51% and 94.63% ± 2.00% respectively with SA and SS (P less then 0.05). At 5000 m, NS level of 79.88P ± 3.60% increased to 82.13 ± 5.87 and 82.88% ± 7.12% with SA and SS respectively (P less then 0.05). The repeated measure ANOVA showed significant difference for altitude (P less then 0.001) and intervention (P = 0.05). In conclusion, singing both either "aloud" or "silently" significantly increased the level of SpO2 in simulated high altitude at 3000 m and above. The study suggests that singing as a potential intervention to improve oxygen saturation at high altitudes. Study with larger sample in hypobaric chamber as well as in real environment is recommended.