Should doctors bargain collectively with HMOs?
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Collective Bargaining↗
Biomedical subjects
S Pisano
Publications and source records attributed to S Pisano.
The vermilion-sharing graft for repairing a vermilionectomy defect.
Lower lip vermilionectomy defects can be repaired with a full-thickness graft of vermilion from the upper lip. The graft width should be approximately one-half that of the lower lip defect, sharing the vermilion between the two lips. The graft should be oriented so that the red, anterior part of the vermilion is placed anteriorly, where it will be most visible. If graft "take" is successful, the result can be aesthetically and functionally excellent, while the donor-site morbidity is minimal.
Aged↗
Superficial femoral vein transposition in Klippel-Trenaunay syndrome.
Use of a superficial femoral vein in competent profunda vein transposition is appropriate in selected cases of Klippel-Trenaunay syndrome; this allows for improvement of venous insufficiency and relief of symptoms secondary to venous stasis.
Adolescent↗
Children's changing attitudes regarding alcohol: a cross-sectional study.
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Alcohol Drinking↗
Iliocaval compression syndrome.
Iliocaval compression syndrome is a significant disorder in a number of patients who have lower extremity venous complaints. The diagnosis may be suspected by positive findings on exercise strain gauge venous plethysmography and unilaterally increased ambulatory venous pressures. The diagnosis is confirmed by ascending and, in some instances, descending venography which demonstrates the iliocaval compression with or without intraluminal web formation. Transstenosis pressure gradients may be measured to confirm the hemodynamic significance of the lesion. We advocate direct operative repair of the iliocaval junction with rerouting of the iliac artery and excision of the iliocaval webs with cephalic vein patch angioplasty. It provided good results in the present study when coupled with an adjunctive regimen of perioperative subcutaneous heparin and warfarin. Further investigation into the exact prevalence and significance of the iliocaval compression syndrome is needed. Only an aggressive approach to patients with lower extremity venous complaints will help clarify the exact prevalence and natural history of this disorder.
Adult↗