Scot Med J
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Review Case Reports
The conservative management of primary pyomyositis abscess in children: case series and review of the literature.
Pyomyositis is a primary pyogenic infection in skeletal muscle, often progressing to abscess formation. It is rare in temperate climates and generally deep-seated within the pelvis with non-specific clinical features, making diagnosis difficult. Magnetic resonance imaging (MRI) is highly sensitive for muscle inflammation and fluid collection, and with its increasing availability is now the investigation of choice. ⋯ Despite the organisms not being identified, each patient was treated successfully with a short (4-7 days) course of intravenous antibiotics followed by 2-6 weeks of oral therapy. There were no recurrences or complications and all made a full recovery. In conclusion, we propose that uncomplicated pyomyositis abscess in children may usually be managed conservatively without the need for open or percutaneous drainage.
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To our knowledge there have been no previous studies that have examined the effect of short messaging service (SMS) text messaging reminders to both mobile and landlines on the 'did not attend' (DNA) rate in adult hospital clinic attendees. Our aim was to determine the effectiveness of a text messaging reminder in improving attendance in return general ophthalmology clinic patients. Ophthalmology clinic patients requiring a follow-up appointment were invited to enter the study. ⋯ Forty-seven percent of patients used mobile phone technology with text messaging capability and 69% responded to the text reminder. In conclusion, routine SMS texting is a cost-effective means of reducing DNAs and should become standard practice. In addition, two-way messaging could allow for further efficiency as advance notification of patient cancellations facilitates re-scheduling of alternative patients.
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The aim of this paper is to examine perceptions of Foundation Year trainees, consultants and senior nurses about the introduction of the Foundation Programme. Specifically, to examine whether Foundation trainees acquire appropriate skills, experience and responsibility. Semi-structured interviews were conducted with 23 F1 doctors, 22 F2 doctors, 23 consultants and 25 nurses from across Scotland in a broad range of specialties. ⋯ Trainees feeling that they are being given insufficient experience, particularly in the F2 year, need to be proactive in addressing this if possible. There is a perception among some consultants and nurses that a process of 'delayed skilling' is taking place, attributable more to reduced hours than Foundation per se. There is a need to follow trainees through to specialty training to ascertain if Foundation has adequately prepared them for run-through training.
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The ability to acquire surgical skills requires consistent practice, and evidence suggests that many of these technical skills can be learnt away from the operating theatre. The aim of this review article is to discuss the importance of surgical simulation today and its various types, exploring the effectiveness of simulation in the clinical setting and its challenges for the future. Surgical simulation offers the opportunity for trainees to practise their surgical skills prior to entering the operating theatre, allowing detailed feedback and objective assessment of their performance. ⋯ Inorganic simulators comprise virtual reality simulators and synthetic bench models. Current evidence suggests that skills acquired through training with simulators, positively transfers to the clinical setting and improves operative outcome. The major challenge for the future revolves around understanding the value of this new technology and developing an educational curriculum that can incorporate surgical simulators.