. Through the process of critical reflection, the author will be able to critically articulate the practice issues from the first person perspective. Guided by these theories, the author will interpret the role and social obligations of theater nurses in the multidisciplinaryteam on perioperative care for patients; examine the power relationships in the context the author is embedded in; critically analyze the personal, sociocultural, historical, and political factors that have influenced theater nurses’ clinical practice. Ultimately, the author might change the actions
The aim of the paper was to present the case of a 64-year-old patient with no significant pathological history, accusing the significant increase in volume of her left buttock, accompanied by sciatic compression and pelvic pain phenomena. Clinical evaluation revealed a large, left gluteal tumor, of regular shape and medium consistency, painless at palpation, causing hyperesthesia in the sciatic territory by compression. The IRM with contrast enhancement described a heterogeneous tumor, measuring about 25 centimeters in diameter, isointense in the T1 and T2 signals, with hypointense areas and imagistic aspect suggesting differential diagnosis between liposarcoma and fibrolipoma. From the imagistic point of view, the origin of the tumor was pelvic, with a threadlike tract in the sciatic hole and development in the gluteal region for the most part. Surgery was decided on a multidisciplinary team including a gynecologist, orthopaedist, and general surgeon, using a double approach through laparotomy and gluteal incision. The first operative step consisted in laparotomy with pelvic tumor dissection at the level of the iliac vessels and its prolongation at the level of the sciatic hole. The large gluteal incision was used during the second step in order to mobilize the tumor form between the gluteal fibers. Subsequent thorough hemostasis was performed with postoperative aspect inspection through both approaches. The postoperative evolution was favorable without immediate or late complications. The histopathological result was fibrolipoma, with good prognosis for the patient. In conclusion, the multidisciplinary surgical approach in this patient presenting with a pelvic tumor with transischial gluteal development was the optimal choice, which led to a favorable outcome in a complex case.
Vincenza Granata, Roberta Fusco, Sergio Venanzio Setola, Elisabetta de Lutio di Castelguidone, Luigi Camera, Salvatore Tafuto, Antonio Avallone, Andrea Belli, Paola Incollingo, Raffaele Palaia, Francesco Izzo and Antonella Petrillo
Gastroenteropancreatic neuroendocrine tumours (GEP-NETs) are a heterogeneous group of tumours. An effective diagnosis requires a multimodal approach that combines evaluation of clinical symptoms, hormonelevels, radiological and nuclear imaging, and histological confirmation. Imaging plays a critical role in NETs diagnosis, prognosis and management, so the radiologists are important members of the multidisciplinary team. During diagnostic work-up two critical issues are present: firstly the need to identify tumor presence and secondly to define the primary site and assess regional and distant metastases.
The most appropriate imaging technique depends on the type of neuroendocrine tumour and the availability of specialized imaging techniques and expertise. There is no general consensus on the most efficient imaging pathway, reflecting the challenge in reliably detection of these tumours.
Sandra Dodgson, Jenny Bryan, Simon Fletcher, Cathy Harrison, Clare Ibbs, April Jones, Paul McLaughlin, Gráinne O’Brien, Sharon Varney, Anne Wareing and Pamela Wick
Members of the multi-disciplinary team involved in delivering haemophilia care face a range of significant clinical and service leadership challenges. These include the developing treatment landscape, the drive towards individualised care, an uneven age structure among haemophilia nurses and constrained budgets. Faced with such challenges, the ASPIRE programme has been established to encourage and support a new generation of haemophilia leaders who are committed to improving haemophilia care across the UK, and beyond. The programme is open to healthcare professional from multiple disciplines, and is designed to support the development of a leadership community comprising members of the haemophilia care team in a way that contrasts with hierarchical leadership and management courses more typically found in the NHS.
Daniela Vrinceanu, Mihai Dumitru, Ioana Eftime, Madalina Ilie, Adrian Stefan, Bogdan Banica, Daniel Mihai Teleanu and Alina Popa-Cherecheanu
BACKGROUND. Odontogenic rhinosinusal suppurations have a high potential for major ocular-orbital and cerebral complications because of the presence of anaerobic bacteria flora, with continuity, contiguity and haematogenous propagation mechanisms. This pathology is often diagnosed in other departments than ENT such as ophthalmology, neurosurgery or OMF surgery.
MATERIAL AND METHODS. We present three clinical cases of odontogenic rhinosinusal suppurations with major complications: a 36-year-old patient with odontogenic pansinusitis complicated with orbital phlegmon and cerebral frontal lobe abscess; a 19-year-old patient with complicated maxillary-ethmoidal-frontal sinusitis complicated with frontal subdural empyema and frontal bone osteomyelitis (with a history of craniofacial trauma one year before); a 66-year-old patient with odontogenic maxillary-ethmoidal sinusitis complicated with orbital apex syndrome.
RESULTS. The treatment was surgical, by external approach, with endoscopic nasal control, in interdisciplinary teams. We have associated massive antibiotic therapy. Surgical drainage for complicated rhinosinusitis should be done in emergency, within the first 24 hours after admission, according to guidelines. The bacteriological examination for aerobic and anaerobic flora can guide the diagnosis - two cases associated maxillo-ethmoidal aspergilloma lesions. The evolution of the cases was favourable.
CONCLUSION. Interdisciplinary teams have successfully solved these complicated odontogenic rhinosinusal suppurations. Two of the cases were admitted and cured within 2 weeks, in the context of very hot weather, which exacerbated dormant dental infections.
Eva Gajdošová, Veronika Bisaki and Silvia Sodomová
The study presents a characterization of an inclusive secondary school in Bratislava and provides information about the forms and methods used in the work of the teachers, school psychologists, special teachers with regard to students with special needs (students with Attention and Hyperactivity Disorder, i.e. ADHD, with learning difficulties, with emotional and behaviour difficulties, etc.), who are educated together with mainstream students. It also provides information on the first results of the measurements of the socio-emotional health of the students in the inclusive school, both as to its overall level (covitality index) and as to the level of the four psychological dimensions of mental health. The pilot project of the inclusive school confirms that inclusive secondary schools and inclusive education operating within the intentions of positive psychology help the students to develop their cognitive and socio-emotional competences, to create favourable attitudes to diversity, to form the students’ scale of positive values and to encourage positive interpersonal relationships, social cohesion and social classroom climate.
Mojca Jensterle, Soncka Jazbinsek, Roman Bosnjak, Mara Popovic, Lorna Zadravec Zaletel, Tina Vipotnik Vesnaver, Barbara Faganel Kotnik and Primoz Kotnik
these critical structures often limits the ability of the surgeon to completely resect the lesion, exposing patients to a high risk of recurrence. The overall 5-year survival rate is high (ranging from 91–98%). Unfortunately, the morbidity rate is equally high with severe neuroendocrine sequelae, impaired social and physical functionality and a negative impact on quality of life (QoL) in all patients. Because of this, strict follow up by a specialized multidisciplinaryteam is paramount. 8 , 9 , 10 , 11 , 12 , 13
High morbidity rates following aggressive
To date, a lot of attention has been paid to the role of research and development ( Cohen et al., 1987 ; Doran et al., 2013 ) and networking ( Boschma, 2005 ; Doran et al., 2012b ; Freel, 2003 ) in the innovation performance of firms. While a number of qualitative studies and case studies have been conducted on the role less tangible factors such as brainstorming and multidisciplinaryteams play in a firm’s innovation performance, there has been relatively little quantitative analysis. Drawing on insights from the Componential Theory of Creativity
Codrut Sarafoleanu, Alexis Vuzitas and Claudiu Manea
23. Chim H., Salgado C.J., Seselgyte R., Wei F.C., Mardini S. - Principles of head and neck reconstruction: an algorithm to guide flap selection. Semin Plast Surg., 2010;24(2):148-154. doi: 10.1055/s-0030-1255332.
24. Original picture: Head lateral anatomy created by Patrick J. Lynch. Acquired form https://commons.wikimedia.org/wiki/File:Lateral_head_anatomy.jpg, under Creative Commons Attribution 2.5 License 2006.
25. Abdulrahman G.O. - The effect of multidisciplinaryteam care on cancer management. Pan
Palliative care in Romania is a relatively new emerging field. Challenges of this specialty, its uniqueness and the several problems posed by a particular category of patients, the chronically ill patients, make this medical specialty a particularly complex one in certain situations, requiring a multidisciplinary team well-prepared in terms of theory and practice. Unlike in the case of most medical specialties, particular emphasis is laid on the “human” side of medical care, this specialty introducing the concept of “total pain”.