To contact us Click HERE
Dr. Donald Berwick and colleagues published last week in JAMA an insightful article titled, Eliminating Waste in US Health Care. In this article, they discuss the cost of health care today and that a reduction in waste could help us save billions over the next few years. They have focused on six areas -- failures of care delivery, failures of care coordination, overtreatment, administrative complexity, pricing failures, and fraud and abuse.
Hear Dr. Berwick discuss the article:
Monday, June 25, 2012
Draining the Gallbladder -- Endoscopy brings new options.
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In April, Jang and colleagues published in Gastroenterology an article titled: Endoscopic ultrasound-guided transmural and percutaneous transhepatic gallbladder drainage are comparable for acute cholecystitis. In this potentially practice changing study, they conducted a prospective randomized trial comparing conventional percutaneous drainage of the gallbladder to EUS-guided transmural drainage. The procedure involved accessing the gallbladder through the duodenal bulb or prepyloric antrum. Through this access point, serial dilators are placed and then a nasobiliary drain. Sedation involved midazolam and meperidine. With 30 patients per group, they found not significant difference in complications and "successful" control of cholecystitis. Conversion to open cholecystectomy was also similar in both groups. Placement of the transmural nasobiliary drain took less than 30 minutes.
Despite the novelty of this procedure and less pain with the endoscopic approach, current evidence does not support its use in patients that can tolerate an operation. Importantly, if general anesthesia is required for the endoscopic procedure, then why not perform a lap chole. I feel a key aspect of this manuscript is the use of a nasobiliary drain. It acts as reminder that the gallbladder needs to come out at some point. With recent use of transpapillary drainage of the gallbladder with double pigtail drains, physicians might get the false impression that drainage is all that is required. The authors highlight that flushing of the nasobiliary drain was required and bile output measured. As we learned with transgastric drains for pancreatic pseudocysts, drains occlude and secondary procedures may be required.
Jang and colleagues fail to mention one benefit of the percutaneous drain. After maturation of the track, additional procedures can be performed by interventional radiology via the cholecystostomy tube. The acute angles of the nasobiliary drain may prevent access to the biliary tree or stone extraction.
Although laparoscopic cholecystectomy is the standard for managing acute cholecystitis, we now have one more option for managing this disease. With wider application, we will see if it remains a safe option.
In April, Jang and colleagues published in Gastroenterology an article titled: Endoscopic ultrasound-guided transmural and percutaneous transhepatic gallbladder drainage are comparable for acute cholecystitis. In this potentially practice changing study, they conducted a prospective randomized trial comparing conventional percutaneous drainage of the gallbladder to EUS-guided transmural drainage. The procedure involved accessing the gallbladder through the duodenal bulb or prepyloric antrum. Through this access point, serial dilators are placed and then a nasobiliary drain. Sedation involved midazolam and meperidine. With 30 patients per group, they found not significant difference in complications and "successful" control of cholecystitis. Conversion to open cholecystectomy was also similar in both groups. Placement of the transmural nasobiliary drain took less than 30 minutes. Despite the novelty of this procedure and less pain with the endoscopic approach, current evidence does not support its use in patients that can tolerate an operation. Importantly, if general anesthesia is required for the endoscopic procedure, then why not perform a lap chole. I feel a key aspect of this manuscript is the use of a nasobiliary drain. It acts as reminder that the gallbladder needs to come out at some point. With recent use of transpapillary drainage of the gallbladder with double pigtail drains, physicians might get the false impression that drainage is all that is required. The authors highlight that flushing of the nasobiliary drain was required and bile output measured. As we learned with transgastric drains for pancreatic pseudocysts, drains occlude and secondary procedures may be required.
Jang and colleagues fail to mention one benefit of the percutaneous drain. After maturation of the track, additional procedures can be performed by interventional radiology via the cholecystostomy tube. The acute angles of the nasobiliary drain may prevent access to the biliary tree or stone extraction.
Although laparoscopic cholecystectomy is the standard for managing acute cholecystitis, we now have one more option for managing this disease. With wider application, we will see if it remains a safe option.
Grey Turner' s Sign
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Ecchymosis or bruising on the abdomen is rarely a good sign on physical exam. Grey Turner's sign is bilateral flank bruising or ecchymosis and is a classic finding of bleeding into the retroperitoneum around the kidneys and pancreas. It is associated with severe acute pancreatitis but may occur following cardiac catheterization with bleeding into the retroperitoneum.
Unfortunately, abdominal wall bruising is common and not always Grey Turner's sign. Location of the bruising really matters. In blunt trauma (e.g. high speed motor vehicle accident), the classic "seat belt sign" is an indicator of potential intra-abdominal injury. Physicians can easily be mislead by subcutaneous injection of insulin or blood thinning medications (e.g. low-molecular weight heparin). These medications can result in impressive abdominal wall bruising that is usually self-limited.
Dr. George Grey Turner was born September 8, 1887 in North Shields, England. As a young surgeon, he traveled extensively throughout America, Canada, and Africa. He was a pioneer in cancer surgery of the esophagus. In 1920, Dr. Grey Turner reported his experience with two patients that died after abdominal exploration for acute pancreatitis. From his experience, he noted periumbilical discoloration (Cullen's sign) and bilateral flank discoloration. He hypothesized that the discoloration was "direct action of pancreatic juice."
Reference:
White H. An Outstanding ISS/SIC Surgeon: George Grey Turner. World Journal of Surgery. 2003. 27:511-513.
Turner G. Local Discoloration of the Abdominal Wall as a Sign of Acute Pancreatitis. British Journal of Surgery. 1920. 7:394-395.
 |
| Figure 1. Grey Turner's Sign. |
Unfortunately, abdominal wall bruising is common and not always Grey Turner's sign. Location of the bruising really matters. In blunt trauma (e.g. high speed motor vehicle accident), the classic "seat belt sign" is an indicator of potential intra-abdominal injury. Physicians can easily be mislead by subcutaneous injection of insulin or blood thinning medications (e.g. low-molecular weight heparin). These medications can result in impressive abdominal wall bruising that is usually self-limited.
Dr. George Grey Turner was born September 8, 1887 in North Shields, England. As a young surgeon, he traveled extensively throughout America, Canada, and Africa. He was a pioneer in cancer surgery of the esophagus. In 1920, Dr. Grey Turner reported his experience with two patients that died after abdominal exploration for acute pancreatitis. From his experience, he noted periumbilical discoloration (Cullen's sign) and bilateral flank discoloration. He hypothesized that the discoloration was "direct action of pancreatic juice."
 |
| Figure 2. Image from original report by Dr. Grey Turner. |
Reference:
White H. An Outstanding ISS/SIC Surgeon: George Grey Turner. World Journal of Surgery. 2003. 27:511-513.
Turner G. Local Discoloration of the Abdominal Wall as a Sign of Acute Pancreatitis. British Journal of Surgery. 1920. 7:394-395.
Eating Soon After A Tummy Tuck Could Get Patients Out Of Hospital Faster
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The American Society for Aesthetic Plastic Surgery (ASAPS) announced that withholding oral intake of food in patients after abdominoplasty ("tummy tuck") may not be necessary, and that feeding patients earlier could allow for quicker discharge after surgery. Findings from a study investigating the impact of early feeding after abdominoplasty on the occurrence of postoperative nausea and vomiting is published in the May/June 2007 issue of the Aesthetic Surgery Journal , the Society's official peer-reviewed journal.
These findings are important because abdominoplasty is a popular cosmetic surgical procedure. According to the Aesthetic Society's statistics abdominoplasty was the fourth most popular surgical procedure in 2006, with 172,457 procedures performed, an increase of 407% from 1997.
Postoperative nausea and vomiting (PONV) is among the most disagreeable experiences associated with surgery, causing dehydration and retching, which can lead to poor wound healing, among other adverse effects. While postoperative management of patients undergoing abdominoplasty has traditionally involved withholding food until patients demonstrate evidence of bowel activity, this practice requires patients to remain in the hospital for the administration of intravenous fluids to prevent dehydration. However, no literature exists to support this practice.
"This study demonstrates that early feeding of tummy tuck patients may prevent the need for postoperative hospital admission for intravenous hydration-at least in those patients who can maintain adequate hydration with oral intake alone-and allow for faster hospital discharge," said Alan Matarasso, MD, a board-certified plastic surgeon in New York, NY, lead author of the study. "While there may be other reasons for admission, routine postoperative admission to prevent dehydration may not be necessary. These findings could change the way we care for our postoperative abdominoplasty patients, improving their comfort and safety, and saving on health care costs."
The study consisted of a retrospective review of the medical records of 22 patients who underwent abdominoplasty, divided into two groups. Group I followed traditional guidelines for oral intake; members of Group II were allowed to consume a regular diet immediately after surgery. All other aspects of postoperative care remained the same. There was no statistical difference in PONV between the two groups.
Although the findings are promising, physicians remain cautiously optimistic about a full transition to ambulatory abdominoplasty.
"Although a number of abdominoplasties are performed as outpatients, for those patients in whom it is deemed necessary, for safety reasons, to undergo the procedure in a hospital this paper demonstrates that early feeding of patients undergoing abdominoplasty is possible. It does not diminish some of the benefits of postoperative hospital admission," adds Foad Nahai, MD, Atlanta plastic surgeon, President of ASAPS and Associate Editor of ASJ . "Achievement of adequate pain control, maintenance of a semi-flexed position, and patient and surgeon preference are important variables to consider when choosing between admission and discharge."
About ASJ
The Aesthetic Surgery Journal is the peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS) and is the most widely read clinical journal in the field of cosmetic surgery, with subscribers in more than 60 countries.
About ASAPS
The American Society for Aesthetic Plastic Surgery, the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery. ASAPS active-member plastic surgeons are certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada.
surgery
These findings are important because abdominoplasty is a popular cosmetic surgical procedure. According to the Aesthetic Society's statistics abdominoplasty was the fourth most popular surgical procedure in 2006, with 172,457 procedures performed, an increase of 407% from 1997.
Postoperative nausea and vomiting (PONV) is among the most disagreeable experiences associated with surgery, causing dehydration and retching, which can lead to poor wound healing, among other adverse effects. While postoperative management of patients undergoing abdominoplasty has traditionally involved withholding food until patients demonstrate evidence of bowel activity, this practice requires patients to remain in the hospital for the administration of intravenous fluids to prevent dehydration. However, no literature exists to support this practice.
"This study demonstrates that early feeding of tummy tuck patients may prevent the need for postoperative hospital admission for intravenous hydration-at least in those patients who can maintain adequate hydration with oral intake alone-and allow for faster hospital discharge," said Alan Matarasso, MD, a board-certified plastic surgeon in New York, NY, lead author of the study. "While there may be other reasons for admission, routine postoperative admission to prevent dehydration may not be necessary. These findings could change the way we care for our postoperative abdominoplasty patients, improving their comfort and safety, and saving on health care costs."
The study consisted of a retrospective review of the medical records of 22 patients who underwent abdominoplasty, divided into two groups. Group I followed traditional guidelines for oral intake; members of Group II were allowed to consume a regular diet immediately after surgery. All other aspects of postoperative care remained the same. There was no statistical difference in PONV between the two groups.
Although the findings are promising, physicians remain cautiously optimistic about a full transition to ambulatory abdominoplasty.
"Although a number of abdominoplasties are performed as outpatients, for those patients in whom it is deemed necessary, for safety reasons, to undergo the procedure in a hospital this paper demonstrates that early feeding of patients undergoing abdominoplasty is possible. It does not diminish some of the benefits of postoperative hospital admission," adds Foad Nahai, MD, Atlanta plastic surgeon, President of ASAPS and Associate Editor of ASJ . "Achievement of adequate pain control, maintenance of a semi-flexed position, and patient and surgeon preference are important variables to consider when choosing between admission and discharge."
About ASJ
The Aesthetic Surgery Journal is the peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS) and is the most widely read clinical journal in the field of cosmetic surgery, with subscribers in more than 60 countries.
About ASAPS
The American Society for Aesthetic Plastic Surgery, the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery. ASAPS active-member plastic surgeons are certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada.
surgery
At 101, Patient Is Nation's Oldest Transcatheter Heart Valve Replacement
To contact us Click HERE
When Doris Snyder celebrated her 102nd birthday on August 10, she was that much closer to the expected birth of her first great-granddaughter who's due to arrive early September. She is very excited about the milestone, which might not have been possible were it not for a cutting-edge, experimental procedure that replaced one of Doris' heart valves weeks earlier when she was 101. The valve had been rendered useless by aortic valve stenosis hardening from calcium deposits that restrict the flow of blood from the heart.
"This procedure could be a major breakthrough for these patients, as they're generally told that nothing can be done for them," said Patrick M. McCarthy, MD, chief of the division of cardiothoracic surgery for Northwestern Memorial Hospital and director of the hospital's Bluhm Cardiovascular Institute and the Heller-Sacks professor of Surgery at Northwestern University's Feinberg School of Medicine.
McCarthy is a co-principal investigator for the clinical trial that provided Doris' new heart valve, which is formally referred to as the Placement of AoRtic TraNscathetER Valve, or PARTNER. The Bluhm Institute is among the trial's pioneering sites. The technique is being evaluated as a course of therapy for patients who are considered too weak to undergo conventional open-heart surgery. It uses expandable-stenting technology to insert a prosthetic valve while the heart continues beating, eliminating the need for cardiopulmonary bypass and its associated risks.
"Patients who are too weak to be surgically treated have very limited options for valve replacement," said Charles J. Davidson, who is also a co-principal investigator for the trial and a professor of Medicine at Northwestern University's Feinberg School of Medicine. Davidson says the procedure builds upon the balloon aortic valvuloplasty, but is a "more durable treatment."
Spry and amazingly keen, Doris had never encountered any major health issues. Moreover, the avid reader who's kept a diary for more than 60 years is usually game to tackle most things that come her way but open-heart surgery was not one of them. S. Chris Malaisrie, MD, a Northwestern Memorial cardiac surgeon and member of the site team evaluating this new procedure, said she wouldn't survive it.
"Doris exemplifies the fact that your state of health is not necessarily defined by your age," said Malaisrie. "She's healthier than a lot of people much younger than her."
Drs. McCarthy and Malaisrie are paid consultants of Edwards LifeSciences, makers of the experimental prosthetic valve.
"This procedure could be a major breakthrough for these patients, as they're generally told that nothing can be done for them," said Patrick M. McCarthy, MD, chief of the division of cardiothoracic surgery for Northwestern Memorial Hospital and director of the hospital's Bluhm Cardiovascular Institute and the Heller-Sacks professor of Surgery at Northwestern University's Feinberg School of Medicine.
McCarthy is a co-principal investigator for the clinical trial that provided Doris' new heart valve, which is formally referred to as the Placement of AoRtic TraNscathetER Valve, or PARTNER. The Bluhm Institute is among the trial's pioneering sites. The technique is being evaluated as a course of therapy for patients who are considered too weak to undergo conventional open-heart surgery. It uses expandable-stenting technology to insert a prosthetic valve while the heart continues beating, eliminating the need for cardiopulmonary bypass and its associated risks.
"Patients who are too weak to be surgically treated have very limited options for valve replacement," said Charles J. Davidson, who is also a co-principal investigator for the trial and a professor of Medicine at Northwestern University's Feinberg School of Medicine. Davidson says the procedure builds upon the balloon aortic valvuloplasty, but is a "more durable treatment."
Spry and amazingly keen, Doris had never encountered any major health issues. Moreover, the avid reader who's kept a diary for more than 60 years is usually game to tackle most things that come her way but open-heart surgery was not one of them. S. Chris Malaisrie, MD, a Northwestern Memorial cardiac surgeon and member of the site team evaluating this new procedure, said she wouldn't survive it.
"Doris exemplifies the fact that your state of health is not necessarily defined by your age," said Malaisrie. "She's healthier than a lot of people much younger than her."
Drs. McCarthy and Malaisrie are paid consultants of Edwards LifeSciences, makers of the experimental prosthetic valve.
Sunday, June 24, 2012
Ventral Hernia Surgery repair
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I haven't been posting anything lately and haven't had much time to play with my new Cameo! On Thursday the 12th I had surgery. I had a large ventral hernia and a small hernia that needed to be repaired. The surgeon had to do it open, so I'm in a lot more pain then if they were to do it laproscopically. I'm just glad it's all over and I am at home recovering. Is very thankful for sick time and a very supportive husband. I hope to be back to normal in about a month or so. Although, it might be interesting to see how creative I can be with all this pain medicine I'm on...LOL!
Halloween Birthday Card
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I read a lot of cardmaking/scrapbooking blogs and fell in love with the paper piecings from myscrapchick.com. Last night in the wee hours of the morning I downloaded the SVG file to my laptop and uploaded it to my Make the Cut software. It took me a couple of hours to do the paper piecings. I liked the layout she had on her website, so I brought it right to my card. The stamps are from My Pink Stamper her new Halloween set. I think it turned out pretty cute! Need to work on my picture taking...
I read a lot of cardmaking/scrapbooking blogs and fell in love with the paper piecings from myscrapchick.com. Last night in the wee hours of the morning I downloaded the SVG file to my laptop and uploaded it to my Make the Cut software. It took me a couple of hours to do the paper piecings. I liked the layout she had on her website, so I brought it right to my card. The stamps are from My Pink Stamper her new Halloween set. I think it turned out pretty cute! Need to work on my picture taking...
Tea pot shaped Mother's Day card
To contact us Click HERE
I created this tea pot shaped card for my Mom for Mother's Day. I dowloaded this cut file http://www.letteringdelights.com/clipart:tea_time_party-10903.html and uploaded it to my SCAL program. I then cut it out with my Silhouette Cameo and paper pieced it together. The tea cup is an svg file I found on google images. I also used an action wobble behind the flower to give it some fun action. I just loved how it turned out. Thanks letteringdelights!
Supples Used: Silhouette Cameo Lettering Delights tea time cut file Bazzill Cardstock Action Wobble Tim Holtz Button My Pink Stamper Stampin Up! Ink Stickles Hero Arts Lace ATG Gun Gel Pen Sizzix Tag die Hot glue gun
I created this tea pot shaped card for my Mom for Mother's Day. I dowloaded this cut file http://www.letteringdelights.com/clipart:tea_time_party-10903.html and uploaded it to my SCAL program. I then cut it out with my Silhouette Cameo and paper pieced it together. The tea cup is an svg file I found on google images. I also used an action wobble behind the flower to give it some fun action. I just loved how it turned out. Thanks letteringdelights!
Supples Used: Silhouette Cameo Lettering Delights tea time cut file Bazzill Cardstock Action Wobble Tim Holtz Button My Pink Stamper Stampin Up! Ink Stickles Hero Arts Lace ATG Gun Gel Pen Sizzix Tag die Hot glue gun
Looking Tired Or Angry May Have More To Do With Facial Aesthetics Than How You Feel, ASPS Study Reveals
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The old saying, "beauty is in the eye of the beholder," has scientifically been proven true. A study in a recent issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), found that variations in eyebrow shape, eyelid position, and wrinkles significantly impact how your facial expressions, and subsequent mood, are perceived by others.
"A key complaint of those seeking facial plastic surgery is that people always tell them they look tired, even though they do not feel tired," said John Persing, MD, ASPS member and study co-author. "We found that variations in eyebrow contour, drooping of the upper eyelid, and wrinkles may be conveying facial expressions that don't necessarily match how patients are feeling."
In the study, a standardized photo of a youthful face was digitally altered to change a number of variables, including eyebrow shape and position; upper and lower eyelid position; upper eyelid drooping and removal of excess skin; and facial wrinkles. Twenty health care workers were given 16 photos and asked to rate, on a scale of 0 to 5, the presence of seven expressions or emotions: tiredness, happiness, surprise, anger, sadness, disgust, and fear. The results for each altered photo were compared with scores from the original unaltered photo. Overall, eyebrow shape had a greater influence than absolute position on perceived mood.
Tiredness
Drooping of the upper eyelid was the biggest indicator of tiredness, according to the study. Simulating skin removal of the upper eyelid, as performed in some eyelid procedures, but not correcting accompanying eyelid ptosis (drooping), resulted in an increase in the perception of tiredness (and sadness). Photos that included an overall elevation of the eyebrows or an increase in the distance between the eyebrow and upper eyelid also increased the perception of tiredness.
Anger & Disgust
Lowering or slanting the inner corner of the eyebrows towards the nose, as well as adding forehead winkles significantly increased the perceived facial expressions of anger and disgust.
Fear & Surprise
Raising the upper eyelids produced an increase in the perception of surprise and fear. Also, raising the outer corner of the eyebrows produced an increase in the perception of surprise.
Sadness
Raising the inner corner of the eyebrows away from the nose was perceived as a sad facial expression.
Happiness
Happiness was perceived by raising the lower eyelid and the presence of crow's feet, which, according to the study, seem to simulate the cheek elevation that occurs with smiling.
"The eyes and their related structures nonverbally communicate a wide range of expressions that are universal to all people," said Dr. Persing. "Therefore facial expression should be a factor in how patients and their plastic surgeons select various rejuvenation procedures. As our findings show, even the slightest modification can elicit profound changes in how others perceive us."
According to ASPS statistics, more than 241,000 eyelid surgeries, 43,000 forehead lifts and 118,400 facelifts were performed in 2007.
Visit plasticsurgery for referrals to ASPS Member Surgeons and to learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 6,700 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
American Society of Plastic Surgeons
"A key complaint of those seeking facial plastic surgery is that people always tell them they look tired, even though they do not feel tired," said John Persing, MD, ASPS member and study co-author. "We found that variations in eyebrow contour, drooping of the upper eyelid, and wrinkles may be conveying facial expressions that don't necessarily match how patients are feeling."
In the study, a standardized photo of a youthful face was digitally altered to change a number of variables, including eyebrow shape and position; upper and lower eyelid position; upper eyelid drooping and removal of excess skin; and facial wrinkles. Twenty health care workers were given 16 photos and asked to rate, on a scale of 0 to 5, the presence of seven expressions or emotions: tiredness, happiness, surprise, anger, sadness, disgust, and fear. The results for each altered photo were compared with scores from the original unaltered photo. Overall, eyebrow shape had a greater influence than absolute position on perceived mood.
Tiredness
Drooping of the upper eyelid was the biggest indicator of tiredness, according to the study. Simulating skin removal of the upper eyelid, as performed in some eyelid procedures, but not correcting accompanying eyelid ptosis (drooping), resulted in an increase in the perception of tiredness (and sadness). Photos that included an overall elevation of the eyebrows or an increase in the distance between the eyebrow and upper eyelid also increased the perception of tiredness.
Anger & Disgust
Lowering or slanting the inner corner of the eyebrows towards the nose, as well as adding forehead winkles significantly increased the perceived facial expressions of anger and disgust.
Fear & Surprise
Raising the upper eyelids produced an increase in the perception of surprise and fear. Also, raising the outer corner of the eyebrows produced an increase in the perception of surprise.
Sadness
Raising the inner corner of the eyebrows away from the nose was perceived as a sad facial expression.
Happiness
Happiness was perceived by raising the lower eyelid and the presence of crow's feet, which, according to the study, seem to simulate the cheek elevation that occurs with smiling.
"The eyes and their related structures nonverbally communicate a wide range of expressions that are universal to all people," said Dr. Persing. "Therefore facial expression should be a factor in how patients and their plastic surgeons select various rejuvenation procedures. As our findings show, even the slightest modification can elicit profound changes in how others perceive us."
According to ASPS statistics, more than 241,000 eyelid surgeries, 43,000 forehead lifts and 118,400 facelifts were performed in 2007.
Visit plasticsurgery for referrals to ASPS Member Surgeons and to learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 6,700 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
American Society of Plastic Surgeons
At 101, Patient Is Nation's Oldest Transcatheter Heart Valve Replacement
To contact us Click HERE
When Doris Snyder celebrated her 102nd birthday on August 10, she was that much closer to the expected birth of her first great-granddaughter who's due to arrive early September. She is very excited about the milestone, which might not have been possible were it not for a cutting-edge, experimental procedure that replaced one of Doris' heart valves weeks earlier when she was 101. The valve had been rendered useless by aortic valve stenosis hardening from calcium deposits that restrict the flow of blood from the heart.
"This procedure could be a major breakthrough for these patients, as they're generally told that nothing can be done for them," said Patrick M. McCarthy, MD, chief of the division of cardiothoracic surgery for Northwestern Memorial Hospital and director of the hospital's Bluhm Cardiovascular Institute and the Heller-Sacks professor of Surgery at Northwestern University's Feinberg School of Medicine.
McCarthy is a co-principal investigator for the clinical trial that provided Doris' new heart valve, which is formally referred to as the Placement of AoRtic TraNscathetER Valve, or PARTNER. The Bluhm Institute is among the trial's pioneering sites. The technique is being evaluated as a course of therapy for patients who are considered too weak to undergo conventional open-heart surgery. It uses expandable-stenting technology to insert a prosthetic valve while the heart continues beating, eliminating the need for cardiopulmonary bypass and its associated risks.
"Patients who are too weak to be surgically treated have very limited options for valve replacement," said Charles J. Davidson, who is also a co-principal investigator for the trial and a professor of Medicine at Northwestern University's Feinberg School of Medicine. Davidson says the procedure builds upon the balloon aortic valvuloplasty, but is a "more durable treatment."
Spry and amazingly keen, Doris had never encountered any major health issues. Moreover, the avid reader who's kept a diary for more than 60 years is usually game to tackle most things that come her way but open-heart surgery was not one of them. S. Chris Malaisrie, MD, a Northwestern Memorial cardiac surgeon and member of the site team evaluating this new procedure, said she wouldn't survive it.
"Doris exemplifies the fact that your state of health is not necessarily defined by your age," said Malaisrie. "She's healthier than a lot of people much younger than her."
Drs. McCarthy and Malaisrie are paid consultants of Edwards LifeSciences, makers of the experimental prosthetic valve.
"This procedure could be a major breakthrough for these patients, as they're generally told that nothing can be done for them," said Patrick M. McCarthy, MD, chief of the division of cardiothoracic surgery for Northwestern Memorial Hospital and director of the hospital's Bluhm Cardiovascular Institute and the Heller-Sacks professor of Surgery at Northwestern University's Feinberg School of Medicine.
McCarthy is a co-principal investigator for the clinical trial that provided Doris' new heart valve, which is formally referred to as the Placement of AoRtic TraNscathetER Valve, or PARTNER. The Bluhm Institute is among the trial's pioneering sites. The technique is being evaluated as a course of therapy for patients who are considered too weak to undergo conventional open-heart surgery. It uses expandable-stenting technology to insert a prosthetic valve while the heart continues beating, eliminating the need for cardiopulmonary bypass and its associated risks.
"Patients who are too weak to be surgically treated have very limited options for valve replacement," said Charles J. Davidson, who is also a co-principal investigator for the trial and a professor of Medicine at Northwestern University's Feinberg School of Medicine. Davidson says the procedure builds upon the balloon aortic valvuloplasty, but is a "more durable treatment."
Spry and amazingly keen, Doris had never encountered any major health issues. Moreover, the avid reader who's kept a diary for more than 60 years is usually game to tackle most things that come her way but open-heart surgery was not one of them. S. Chris Malaisrie, MD, a Northwestern Memorial cardiac surgeon and member of the site team evaluating this new procedure, said she wouldn't survive it.
"Doris exemplifies the fact that your state of health is not necessarily defined by your age," said Malaisrie. "She's healthier than a lot of people much younger than her."
Drs. McCarthy and Malaisrie are paid consultants of Edwards LifeSciences, makers of the experimental prosthetic valve.
Saturday, June 23, 2012
Home Based Business
To contact us Click HERE
* Solar Pool Covers and Reels For Above Ground Pools
* Solar Pool Covers Are Green - Save Green
* Bed Rail Safety For A Child
* Bed Rails For Race Car Beds
* Twin Bed Rails Ensure Safety Within your Baby
* Tips on Luring Traffic to Your Website
* Dani Johnson Just May Be Your Inspiration
* Key References for Internet Marketing Success
* The Real Advantages Of Hot Tub Coverings
* Washer Distributors
* How To Work From Home- Keys To Success
* Learn More About Dani Johnson
* Making Money By Selling Gold Jewelry
* Survey Jobs From Home
* No Scam Income With Real Paid Surveys
* You Have The Capacity to Unblock The Gremlins And Fly With The Eagles
* Get Professional Help Through Internet To Remodel Your Home
* The Fundamentals Of Earning Income From Home
* Starting a Home Based Business and Goal Setting
* Survey Jobs From Home For Some Extra Cash
* 3 Things To Remember When Using Affiliate Marketing Basics Beginner's Guide
* Genuine Facts Why You Should Quit Your Office Job And Work From Home
* Make Money Online by Online writing - Discover How You Can Start Today
* A Brief Process of Order Fulfilment
* Work From Home Ideas
* Prepare Things To Create And Sell
* Organizing With Reinforced File Folders
* Starting a Cupcake Business - Is it the suited business for you?
* How To Start A Cupcake Business From Home
* Optimal Work Conditions In Garden Offices
* Solar Pool Covers Are Green - Save Green
* Bed Rail Safety For A Child
* Bed Rails For Race Car Beds
* Twin Bed Rails Ensure Safety Within your Baby
* Tips on Luring Traffic to Your Website
* Dani Johnson Just May Be Your Inspiration
* Key References for Internet Marketing Success
* The Real Advantages Of Hot Tub Coverings
* Washer Distributors
* How To Work From Home- Keys To Success
* Learn More About Dani Johnson
* Making Money By Selling Gold Jewelry
* Survey Jobs From Home
* No Scam Income With Real Paid Surveys
* You Have The Capacity to Unblock The Gremlins And Fly With The Eagles
* Get Professional Help Through Internet To Remodel Your Home
* The Fundamentals Of Earning Income From Home
* Starting a Home Based Business and Goal Setting
* Survey Jobs From Home For Some Extra Cash
* 3 Things To Remember When Using Affiliate Marketing Basics Beginner's Guide
* Genuine Facts Why You Should Quit Your Office Job And Work From Home
* Make Money Online by Online writing - Discover How You Can Start Today
* A Brief Process of Order Fulfilment
* Work From Home Ideas
* Prepare Things To Create And Sell
* Organizing With Reinforced File Folders
* Starting a Cupcake Business - Is it the suited business for you?
* How To Start A Cupcake Business From Home
* Optimal Work Conditions In Garden Offices
Iraq War Has Led To Surgical Advances
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Through hard experience, U.S. military doctors and civilian surgeons in Iraq have made meaningful strides in managing devastating injuries suffered by soldiers and Iraqi victims. The gains are highlighted in special articles in the March issue of The Journal of Craniofacial Surgery published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.
Writing onboard a C-17 MEDEVAC flight from Iraq, Col. W. Bryan Gamble, M.D., of the U.S. Army Medical Corps shares his "humbling" reflections on progress in the fields of trauma and critical care in the five years since the start of the Iraq War. Through intense co-operative efforts and ongoing changes to treatment guidelines and protocols, the survival rate for soldiers wounded in Iraq now exceeds 90 percent "a monumental leap forward in survival from earlier conflicts," according to Dr. Gamble.
Ongoing data collection and analysis have led to continuous improvement in every area of trauma care. Among the many important innovations has been the introduction of civilian trauma experts and weekly video conferences to ensure continuity of care for injured soldiers throughout the Military Health System and into the Veterans' Administration system.
As soldiers survive combinations of injuries that would not previously have been survivable, unprecedented surgical insights have emerged. For example, relatively simple measures to avoid hypothermia have significantly increased body temperatures by the time wounded soldiers arrive at combat hospitals thus improving their chances of survival.
"Constant and critical analysis of fundamental patient data points can lead to profound changes and improvement in survival," Dr. Gamble writes. "Application of these lessons into training doctrines for standards of practice will ensure optimal outcomes for our patients of today and into the future for soldiers and civilians alike, should the need ever arise."
On the ground in Iraq, Dr. Raja K. Kummoona writes of the experience in treating civilians with missile injuries caused by bullets, shrapnel, etc. to the face and mouth area at the Hospital of Specialized Surgery in Baghdad. During the first two years of the war, Dr. Kummoona's unit operated on 141 patients with missile injuries of the orofacial region.
Dr. Kummoona outlines his unit's surgical approach, including the use of bone grafts to reconstruct the mandible (lower jaw) and soft tissue reconstruction of the lips and cheeks. The injuries are characteristics of the ongoing conflict in Iraq, which Dr. Kummoona characterizes as "a combination of war crime and assault, and civil unrest and terrorism." He writes, "As surgeons, we cannot influence the surge of this violence, but we are surely called upon to care for its victims."
In a Special Editorial, Dr. Mutaz B. Habal, Director of Tampa Bay Craniofacial Center in Tampa, Fla., and Editor-in-Chief of JCS, underscores the need to integrate the knowledge of military and civilian surgeons so as to improve outcomes for the casualties of modern war.
Lessons from the experience of military surgeons will be applicable to the daily practice of civilian craniofacial surgeons in treating patients with head injuries, Dr. Habal believes. Some of the techniques evolved in treating Iraq War casualties for example, preservation of skull bone for use in later reconstruction may also have implications for reconstructive surgery in patients with certain brain tumors or extensive skin cancers. Dr. Habal concludes, "The final is a constant learning experience between the civilian surgeons and the military surgeons to treat the young people injured for their improved outcome, which we are witnessing as we write these lines."
About The Journal of Craniofacial Surgery
The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. Affiliates include 13 major specialty societies around the world, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the American Society of Maxillofacial Surgeons, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the Asian Pacific Craniofacial Association, the Brazilian Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Thai Cleft and Craniofacial Association, and the World Craniofacial Foundation.
About Wolters Kluwer Health
Wolters Kluwer Health (Conshohocken, PA), a division of Wolters Kluwer, is a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons; electronic information providers, such as Ovid, Medi-Span and ProVation; and pharmaceutical information providers such as Adis International and Source®. For more information, visit WKHealth.
Wolters Kluwer is a leading global information services and publishing company. The company provides products and services globally for professionals in the health, tax, accounting, corporate, financial services, legal, and regulatory sectors. Wolters Kluwer has annual revenues (2007) of ?‚¬3.4 billion ($4.8 billion), maintains operations in over 33 countries across Europe, North America, and Asia Pacific and employs approximately 19,544 people worldwide. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Visit WoltersKluwer for information about our market positions, customers, brands, and organization.
Lippincott Williams & Wilkins
530 Walnut St.
Philadelphia, PA 19106
United States
lww
Writing onboard a C-17 MEDEVAC flight from Iraq, Col. W. Bryan Gamble, M.D., of the U.S. Army Medical Corps shares his "humbling" reflections on progress in the fields of trauma and critical care in the five years since the start of the Iraq War. Through intense co-operative efforts and ongoing changes to treatment guidelines and protocols, the survival rate for soldiers wounded in Iraq now exceeds 90 percent "a monumental leap forward in survival from earlier conflicts," according to Dr. Gamble.
Ongoing data collection and analysis have led to continuous improvement in every area of trauma care. Among the many important innovations has been the introduction of civilian trauma experts and weekly video conferences to ensure continuity of care for injured soldiers throughout the Military Health System and into the Veterans' Administration system.
As soldiers survive combinations of injuries that would not previously have been survivable, unprecedented surgical insights have emerged. For example, relatively simple measures to avoid hypothermia have significantly increased body temperatures by the time wounded soldiers arrive at combat hospitals thus improving their chances of survival.
"Constant and critical analysis of fundamental patient data points can lead to profound changes and improvement in survival," Dr. Gamble writes. "Application of these lessons into training doctrines for standards of practice will ensure optimal outcomes for our patients of today and into the future for soldiers and civilians alike, should the need ever arise."
On the ground in Iraq, Dr. Raja K. Kummoona writes of the experience in treating civilians with missile injuries caused by bullets, shrapnel, etc. to the face and mouth area at the Hospital of Specialized Surgery in Baghdad. During the first two years of the war, Dr. Kummoona's unit operated on 141 patients with missile injuries of the orofacial region.
Dr. Kummoona outlines his unit's surgical approach, including the use of bone grafts to reconstruct the mandible (lower jaw) and soft tissue reconstruction of the lips and cheeks. The injuries are characteristics of the ongoing conflict in Iraq, which Dr. Kummoona characterizes as "a combination of war crime and assault, and civil unrest and terrorism." He writes, "As surgeons, we cannot influence the surge of this violence, but we are surely called upon to care for its victims."
In a Special Editorial, Dr. Mutaz B. Habal, Director of Tampa Bay Craniofacial Center in Tampa, Fla., and Editor-in-Chief of JCS, underscores the need to integrate the knowledge of military and civilian surgeons so as to improve outcomes for the casualties of modern war.
Lessons from the experience of military surgeons will be applicable to the daily practice of civilian craniofacial surgeons in treating patients with head injuries, Dr. Habal believes. Some of the techniques evolved in treating Iraq War casualties for example, preservation of skull bone for use in later reconstruction may also have implications for reconstructive surgery in patients with certain brain tumors or extensive skin cancers. Dr. Habal concludes, "The final is a constant learning experience between the civilian surgeons and the military surgeons to treat the young people injured for their improved outcome, which we are witnessing as we write these lines."
About The Journal of Craniofacial Surgery
The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. Affiliates include 13 major specialty societies around the world, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the American Society of Maxillofacial Surgeons, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the Asian Pacific Craniofacial Association, the Brazilian Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Thai Cleft and Craniofacial Association, and the World Craniofacial Foundation.
About Wolters Kluwer Health
Wolters Kluwer Health (Conshohocken, PA), a division of Wolters Kluwer, is a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons; electronic information providers, such as Ovid, Medi-Span and ProVation; and pharmaceutical information providers such as Adis International and Source®. For more information, visit WKHealth.
Wolters Kluwer is a leading global information services and publishing company. The company provides products and services globally for professionals in the health, tax, accounting, corporate, financial services, legal, and regulatory sectors. Wolters Kluwer has annual revenues (2007) of ?‚¬3.4 billion ($4.8 billion), maintains operations in over 33 countries across Europe, North America, and Asia Pacific and employs approximately 19,544 people worldwide. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Visit WoltersKluwer for information about our market positions, customers, brands, and organization.
Lippincott Williams & Wilkins
530 Walnut St.
Philadelphia, PA 19106
United States
lww
Government Sees The Light On Cosmetic Laser Deregulation, UK
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With news that the Government will not deregulate Class 3B and 4 Lasers and Intense Pulse Light Sources (IPL) on 1 October 2008 as planned*, Jenny Driscoll, Health Campaigner, Which? says:
"We're delighted the Government has listened to consumers and industry, deciding not to deregulate cosmetic laser treatments in October**. Thousands more people would have been needlessly harmed or scarred if the proposals had gone ahead***, and it is encouraging to see that the consultation process has been effective.
"Now the Government must take the time to have a serious, in-depth look at this rapidly expanding industry. Current and future regulations must not only be effective and robust, but policed efficiently in clinics across the country, making sure consumers are protected. Laser treatments should change lives for the better, not the worse."
* Private and Voluntary Healthcare, Care Standards Act 2000, Regulations and National Minimum Standards, Consultation Document
** The Government published its consultation paper on Private and Voluntary Health Care: Care Standards Act 2000' in March 2008 which included partial deregulation of lasers and intense pulsed light sources - Class 3B or Class 4 laser products and intense pulsed light (IPL).
***The Government stated that cosmetic laser deregulation could cost the NHS an extra ??1.8 million a year as well as doubling the rate of 'adverse incidents' such as people getting burns. (
"We're delighted the Government has listened to consumers and industry, deciding not to deregulate cosmetic laser treatments in October**. Thousands more people would have been needlessly harmed or scarred if the proposals had gone ahead***, and it is encouraging to see that the consultation process has been effective.
"Now the Government must take the time to have a serious, in-depth look at this rapidly expanding industry. Current and future regulations must not only be effective and robust, but policed efficiently in clinics across the country, making sure consumers are protected. Laser treatments should change lives for the better, not the worse."
* Private and Voluntary Healthcare, Care Standards Act 2000, Regulations and National Minimum Standards, Consultation Document
** The Government published its consultation paper on Private and Voluntary Health Care: Care Standards Act 2000' in March 2008 which included partial deregulation of lasers and intense pulsed light sources - Class 3B or Class 4 laser products and intense pulsed light (IPL).
***The Government stated that cosmetic laser deregulation could cost the NHS an extra ??1.8 million a year as well as doubling the rate of 'adverse incidents' such as people getting burns. (
ASAPS Partners With SAGE In 2010 To Publish The Aesthetic Surgery Journal
To contact us Click HERE
The American Society for Aesthetic Plastic Surgery (ASAPS) has partnered with SAGE to publish the Aesthetic Surgery Journal (ASJ) beginning in 2010. A peer-reviewed international journal indexed in MEDLINE/PubMed, ASJ focuses on scientific developments and clinical techniques in aesthetic surgery,
ASJ is an official publication of the 2400-member ASAPS and is the official English-language journal of eleven major international societies of plastic, aesthetic and reconstructive surgery from South America, Central America, Europe, Asia, and the Middle East. It is also an official journal of The Rhinoplasty Society.
"The selection of SAGE as our publishing partner will help facilitate the wider dissemination of ASJ content," said Foad Nahai, MD, Editor -in-Chiefof ASJ. "We are confident that SAGE can meet all aspects of the journal's needs, especially with regard to quality control, international marketing and distribution, and enhancement of the journal's electronic publishing capabilities."
ASJ features original research and review articles on topics relevant to the safe and effective practice of aesthetic surgery including anatomical studies, outcomes of clinical techniques, and patient safety. ASJ also includes Continuing Medical Education (CME) articles and exams.
"SAGE is very pleased to have been chosen as the ASAPS' publishing partner for their prestigious and widely-read journal," said Jayne Marks, SAGE Vice-President and Editorial Director, Journals. "The Aesthetic Surgery Journal is an important addition not just to our growing list of science, technology and medicine journals, but also to the depth of our society publishing program."
The first SAGE published issue of the Aesthetic Surgery Journal (ISSN: 1090-820X) will begin with Volume 30 in January 2010. aestheticsurgeryjournal
SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars, practitioners, researchers, and students spanning a wide range of subject areas including business, humanities, social sciences, and science, technology, and medicine. A privately owned corporation, SAGE has principal offices in Los Angeles, London, New Delhi, Singapore and Washington DC. sagepublications
Source
American Society for Aesthetic Plastic Surgery (ASAPS)
ASJ is an official publication of the 2400-member ASAPS and is the official English-language journal of eleven major international societies of plastic, aesthetic and reconstructive surgery from South America, Central America, Europe, Asia, and the Middle East. It is also an official journal of The Rhinoplasty Society.
"The selection of SAGE as our publishing partner will help facilitate the wider dissemination of ASJ content," said Foad Nahai, MD, Editor -in-Chiefof ASJ. "We are confident that SAGE can meet all aspects of the journal's needs, especially with regard to quality control, international marketing and distribution, and enhancement of the journal's electronic publishing capabilities."
ASJ features original research and review articles on topics relevant to the safe and effective practice of aesthetic surgery including anatomical studies, outcomes of clinical techniques, and patient safety. ASJ also includes Continuing Medical Education (CME) articles and exams.
"SAGE is very pleased to have been chosen as the ASAPS' publishing partner for their prestigious and widely-read journal," said Jayne Marks, SAGE Vice-President and Editorial Director, Journals. "The Aesthetic Surgery Journal is an important addition not just to our growing list of science, technology and medicine journals, but also to the depth of our society publishing program."
The first SAGE published issue of the Aesthetic Surgery Journal (ISSN: 1090-820X) will begin with Volume 30 in January 2010. aestheticsurgeryjournal
SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars, practitioners, researchers, and students spanning a wide range of subject areas including business, humanities, social sciences, and science, technology, and medicine. A privately owned corporation, SAGE has principal offices in Los Angeles, London, New Delhi, Singapore and Washington DC. sagepublications
Source
American Society for Aesthetic Plastic Surgery (ASAPS)
At 101, Patient Is Nation's Oldest Transcatheter Heart Valve Replacement
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When Doris Snyder celebrated her 102nd birthday on August 10, she was that much closer to the expected birth of her first great-granddaughter who's due to arrive early September. She is very excited about the milestone, which might not have been possible were it not for a cutting-edge, experimental procedure that replaced one of Doris' heart valves weeks earlier when she was 101. The valve had been rendered useless by aortic valve stenosis hardening from calcium deposits that restrict the flow of blood from the heart.
"This procedure could be a major breakthrough for these patients, as they're generally told that nothing can be done for them," said Patrick M. McCarthy, MD, chief of the division of cardiothoracic surgery for Northwestern Memorial Hospital and director of the hospital's Bluhm Cardiovascular Institute and the Heller-Sacks professor of Surgery at Northwestern University's Feinberg School of Medicine.
McCarthy is a co-principal investigator for the clinical trial that provided Doris' new heart valve, which is formally referred to as the Placement of AoRtic TraNscathetER Valve, or PARTNER. The Bluhm Institute is among the trial's pioneering sites. The technique is being evaluated as a course of therapy for patients who are considered too weak to undergo conventional open-heart surgery. It uses expandable-stenting technology to insert a prosthetic valve while the heart continues beating, eliminating the need for cardiopulmonary bypass and its associated risks.
"Patients who are too weak to be surgically treated have very limited options for valve replacement," said Charles J. Davidson, who is also a co-principal investigator for the trial and a professor of Medicine at Northwestern University's Feinberg School of Medicine. Davidson says the procedure builds upon the balloon aortic valvuloplasty, but is a "more durable treatment."
Spry and amazingly keen, Doris had never encountered any major health issues. Moreover, the avid reader who's kept a diary for more than 60 years is usually game to tackle most things that come her way but open-heart surgery was not one of them. S. Chris Malaisrie, MD, a Northwestern Memorial cardiac surgeon and member of the site team evaluating this new procedure, said she wouldn't survive it.
"Doris exemplifies the fact that your state of health is not necessarily defined by your age," said Malaisrie. "She's healthier than a lot of people much younger than her."
Drs. McCarthy and Malaisrie are paid consultants of Edwards LifeSciences, makers of the experimental prosthetic valve.
"This procedure could be a major breakthrough for these patients, as they're generally told that nothing can be done for them," said Patrick M. McCarthy, MD, chief of the division of cardiothoracic surgery for Northwestern Memorial Hospital and director of the hospital's Bluhm Cardiovascular Institute and the Heller-Sacks professor of Surgery at Northwestern University's Feinberg School of Medicine.
McCarthy is a co-principal investigator for the clinical trial that provided Doris' new heart valve, which is formally referred to as the Placement of AoRtic TraNscathetER Valve, or PARTNER. The Bluhm Institute is among the trial's pioneering sites. The technique is being evaluated as a course of therapy for patients who are considered too weak to undergo conventional open-heart surgery. It uses expandable-stenting technology to insert a prosthetic valve while the heart continues beating, eliminating the need for cardiopulmonary bypass and its associated risks.
"Patients who are too weak to be surgically treated have very limited options for valve replacement," said Charles J. Davidson, who is also a co-principal investigator for the trial and a professor of Medicine at Northwestern University's Feinberg School of Medicine. Davidson says the procedure builds upon the balloon aortic valvuloplasty, but is a "more durable treatment."
Spry and amazingly keen, Doris had never encountered any major health issues. Moreover, the avid reader who's kept a diary for more than 60 years is usually game to tackle most things that come her way but open-heart surgery was not one of them. S. Chris Malaisrie, MD, a Northwestern Memorial cardiac surgeon and member of the site team evaluating this new procedure, said she wouldn't survive it.
"Doris exemplifies the fact that your state of health is not necessarily defined by your age," said Malaisrie. "She's healthier than a lot of people much younger than her."
Drs. McCarthy and Malaisrie are paid consultants of Edwards LifeSciences, makers of the experimental prosthetic valve.
Thursday, June 21, 2012
Snoopy flying by to say Happy Birthday!
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- I made this really fun Snoopy card for my Father-In-Law's birthday over the weekend. I found the idea on splitcoaststampers and changed it up to make it my own. Instead of using trees I used a city backgaround by Hero Arts.
- Supplies Used: Silhouette Cameo, Silhouette Design software, Snoopy rubber stamp, Hero Arts silly scape rubber stamp, bazzill cardstock, Stampin Up cardstock, copic markers, stickles, foam dots, My Pink Stamper stamps, twine, glossy accents, gems, Stampin Up sponges, and Stampin Up ink.
Blessings at Easter!
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Supplies Used: Bazzill swiss dot cardstock, Reminisce Easter Paper (from last year), white shimmery card stock, nestabilities, sizzix vagabond, gems, SU! basic black ink, copic markers, Peachy Keen easter stamps, My Pink Stamper, atg gun, foam dots, and paper trimmer.
- I made this at the beginning of the month for Easter. I followed a card sketch I saw on Peachy Keen stamps challenge blog to get me started (I wasn't able to send it in for the challenge as it was past the deadline.)
Supplies Used: Bazzill swiss dot cardstock, Reminisce Easter Paper (from last year), white shimmery card stock, nestabilities, sizzix vagabond, gems, SU! basic black ink, copic markers, Peachy Keen easter stamps, My Pink Stamper, atg gun, foam dots, and paper trimmer.
Happy Easter!
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Supplies Used: white shimmery cardtstock, Reminisce Easter paper (from last year), bazzill swiss dot card stock, gems, twine, bazzill card stock, stickles, My Pink Stamper, swiss dot cuttlebug embossing folder, sizzix big kick, atg gun, foam dots, SCAL, Silhouette Cameo, corner rounder punch, and paper trimmer.
 |
| Happy Easter Card! |
- Here's another Easter card I made. I followed another card sketch I found on the Peachy Keen challenge blog site. They really help me get started in a design. For this card I paper pieced a sleepy bunny I bought from myscrapchick.com. I uploaded the file to my computer and imported it to my SCAL program. It didn't take very long to piece together and it's super cute! I'm really loving the Silhouette Cameo over the Cricut Expression. It cuts awesome and I have a lot more options!
Supplies Used: white shimmery cardtstock, Reminisce Easter paper (from last year), bazzill swiss dot card stock, gems, twine, bazzill card stock, stickles, My Pink Stamper, swiss dot cuttlebug embossing folder, sizzix big kick, atg gun, foam dots, SCAL, Silhouette Cameo, corner rounder punch, and paper trimmer.
Video Game Controller Shaped Card
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I purchased the video game controller from the Silhouette design studio library for .99 cents. I imported the file and then welded two controllers together. This is what you're seeing in this picture. 
I then ungrouped one of the controllers and deleted all the buttons. For some reason it won't let me flip the controller to get the buttons on the right side. Doing that gives you this fabulous fun card for any gamer!
Here's the finished product! 
Here's a better shot! I saw this somewhere on splitcoaststampers and I just new I could make my own! I really hope that my nephew likes it! Thanks for looking!
I purchased the video game controller from the Silhouette design studio library for .99 cents. I imported the file and then welded two controllers together. This is what you're seeing in this picture. I then ungrouped one of the controllers and deleted all the buttons. For some reason it won't let me flip the controller to get the buttons on the right side. Doing that gives you this fabulous fun card for any gamer!Here's the finished product! Here's a better shot! I saw this somewhere on splitcoaststampers and I just new I could make my own! I really hope that my nephew likes it! Thanks for looking!
Tea pot shaped Mother's Day card
To contact us Click HERE
I created this tea pot shaped card for my Mom for Mother's Day. I dowloaded this cut file http://www.letteringdelights.com/clipart:tea_time_party-10903.html and uploaded it to my SCAL program. I then cut it out with my Silhouette Cameo and paper pieced it together. The tea cup is an svg file I found on google images. I also used an action wobble behind the flower to give it some fun action. I just loved how it turned out. Thanks letteringdelights!
Supples Used: Silhouette Cameo Lettering Delights tea time cut file Bazzill Cardstock Action Wobble Tim Holtz Button My Pink Stamper Stampin Up! Ink Stickles Hero Arts Lace ATG Gun Gel Pen Sizzix Tag die Hot glue gun
I created this tea pot shaped card for my Mom for Mother's Day. I dowloaded this cut file http://www.letteringdelights.com/clipart:tea_time_party-10903.html and uploaded it to my SCAL program. I then cut it out with my Silhouette Cameo and paper pieced it together. The tea cup is an svg file I found on google images. I also used an action wobble behind the flower to give it some fun action. I just loved how it turned out. Thanks letteringdelights!
Supples Used: Silhouette Cameo Lettering Delights tea time cut file Bazzill Cardstock Action Wobble Tim Holtz Button My Pink Stamper Stampin Up! Ink Stickles Hero Arts Lace ATG Gun Gel Pen Sizzix Tag die Hot glue gun
Tuesday, June 19, 2012
(N) PRC December 2007 Nursing Licensure (Board) Examination (NLE) Results
To contact us Click HERE
Roll of Successful Examinees in theNURSE LICENSURE EXAMINATIONHeld on JUNE 1 & 2, 2008Released on JULY 23, 2008 18134 NA-AG, FELINA WACAY18135 NA-OY, MARK FRANCIS OLAT18136 NAAMAN, MARIA OTHELA RESOS18137 NAANEP, JANESSA CABAÑERO18138 NAANEP, LALAINE CEREZO18139 NABATA, BENJAMIN BERMAS18140 NABAYSA, JACQUILINE GALLETES18141 NABLE, ELDEE MANUEL18142 NABLO, MARIA RAVIA DOSADO18143 NABOA, MARYJOY
Nursing Informations, Study and Review Guides, Latest News and Updates, Health, all about nursing...
Nursing Informations, Study and Review Guides, Latest News and Updates, Health, all about nursing...
(O) PRC December 2007 Nursing Licensure (Board) Examination (NLE) Results
To contact us Click HERE
Roll of Successful Examinees in theNURSE LICENSURE EXAMINATIONHeld on JUNE 1 & 2, 2008Released on JULY 23, 2008 18653 OANDASAN, DJIMBO ALEXIS FARINAS18654 OANDASAN, INGRID JODELLE DAGURO18655 OANDASAN, JEFF IAN DAGURO18656 OBA, JIAN FRANCESCA MACAM18657 OBAOB, ERLINDA PASCUAL18658 OBAÑANA, MISHELLE AMBAL18659 OBCEMEA, KRISTINE MAAÑO18660 OBDIN, AILENE GINA CABILING18661 OBEDENCIO, CHRISTINE JAN
Nursing Informations, Study and Review Guides, Latest News and Updates, Health, all about nursing... 
Nursing Informations, Study and Review Guides, Latest News and Updates, Health, all about nursing...
(Q) PRC December 2007 Nursing Licensure (Board) Examination (NLE) Results
To contact us Click HERE
Roll of Successful Examinees in theNURSE LICENSURE EXAMINATIONHeld on JUNE 1 & 2, 2008Released on JULY 23, 2008 21086 QUARIO, ERIKA PEARL MARTINEZ21087 QUARTEROS, ALVARA CASING21088 QUE, CHARMAINE BITARA21089 QUE, JOSEPH ILOG21090 QUE, SHIELAMAE SOON21091 QUEBRAL, FATIMA ANGELICA CHANG21092 QUEBRAL, JINGKY MIRANDA21093 QUEBRAL, RICHARD CARTIE DOMONDON21094 QUEJA, RAFAEL ABASOLO21095 QUEJADA,
Nursing Informations, Study and Review Guides, Latest News and Updates, Health, all about nursing... 
Nursing Informations, Study and Review Guides, Latest News and Updates, Health, all about nursing...
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