Kaohsiung J Med Sci
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Kaohsiung J Med Sci · Sep 2009
Infusing cultural competence training into the curriculum: describing the development of culturally sensitive training on dementia communication.
The need for training in cultural sensitivity and cultural competence exists at every level of medical care. This discussion reports on an interdisciplinary project to infuse cultural competence training in dementia communication care into nursing and nurse assistant training. We describe the core curriculum and its subsequent cross-cultural and linguistic adaptations to meet multiple educational and training needs of language-challenged learners, and discuss implications for others developing cross-disciplinary curricula.
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Kaohsiung J Med Sci · Aug 2009
Comparison of laparoscopic adrenalectomy with open surgery for adrenal tumors.
The role of laparoscopy in the management of adrenal tumors is well established. However, there are very few head-to-head comparisons between laparoscopic and open methods at the same institution. We retrospectively evaluated the operative and postoperative parameters of laparoscopic adrenalectomy for adrenal tumors and compared the results with those of traditional open adrenalectomy. ⋯ There was no mortality in either group. Laparoscopic adrenalectomy is a safe, effective and minimally invasive approach with the advantages of better cosmesis, less blood loss, shorter hospital stay and more rapid recovery. We recommend that laparoscopic adrenalectomy is considered as the gold standard procedure for adrenal tumors, irrespective of whether the tumor is benign or malignant.
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Kaohsiung J Med Sci · Aug 2009
Minimally invasive distal metatarsal osteotomy for mild-to-moderate hallux valgus deformity.
Minimally invasive surgery has recently been introduced for foot and ankle surgery, and hallux valgus surgery is no exception. The purpose of our study was to analyze the early results and to present our experience of minimally invasive distal metatarsal osteotomy in correcting mild-to-moderate hallux valgus deformities. Between September 2005 and December 2006, 31 consecutive patients (47 feet) with mild-to-moderate hallux valgus deformities underwent minimally invasive distal metatarsal osteotomies. ⋯ On weight-bearing anteroposterior foot radiographs, the mean hallux valgus angle and first intermetatarsal angle corrections were 11.8 degrees and 6.3 degrees, respectively, which is a statistically significant difference (p < 0.001) between the preoperative and postoperative status. Here, minimally invasive distal metatarsal osteotomy was associated with good satisfaction, functional improvement and low complication rates. This technique offers an effective, safe and simple way to treat hallux valgus with a first intermetatarsal angle less than 15 degrees.
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Kaohsiung J Med Sci · Jun 2009
Case ReportsA rare occipital condyle fracture in a patient with a minor head injury.
Occipital condyle fracture (OCF) is an uncommon but potentially fatal disease entity. It is most commonly identified in patients suffering from severe craniocerebral trauma. The advent of computed tomography has made early detection possible. ⋯ Delayed diagnosis, however, may result in neurologic deterioration due to potential displacement of fractured condylar fragments. Here we report a case of isolated, stable OCF in a patient with a minor head injury. A high level of clinical awareness of this rare disease entity is imperative for the management of traumatized patients, especially for those who have minor head injuries but persistent neck pain.
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Kaohsiung J Med Sci · Jun 2009
Measurement of the functional status of patients with different types of muscular dystrophy.
Muscular dystrophy (MD) comprises a group of diseases characterized by progressive muscle weakness that induces functional deterioration. Clinical management requires the use of a well-designed scale to measure patients' functional status. This study aimed to investigate the quality of the functional scales used to assess patients with different types of MD. ⋯ The results of this study demonstrate the acceptability of the different applications used for measuring functional status in patients with different types of MD. Some of the limitations of these measures as applied to MD should be carefully considered, especially in patients with slowly progressive MD. We suggest that these applications be used in combination with other measures, or that a complicated instrument capable of evaluating the various levels of functional status be used.