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PubMed2001

[Medical complications and medical legal pitfalls concerning interventional radiological procedures on the breast].

Radiological interventional procedures on the breast are still work in progress. Initiation of percutaneous macrobiopsy techniques such as stereotactic or ultrasound-guided core biopsy, mammotomy or Abbi Site-Select procedures allows the physician to expect a high accuracy for the diagnosis of non palpable suspected breast abnormalities, thus eliminating the need for at least half of the surgical biopsies done for this indication. Furthermore, the absence of any lasting post-procedural changes on follow-up mammography contrasts with the scarring associated with traditional surgical open biopsy and obviates confusion in subsequent mammographic interpretation. Recently, development of percutaneous radiofrequency or cryotherapy ablation of breast cancer has been related. All these cost-saving procedures lead to medical and potential medical legal pitfalls that will be discussed.

Biopsy, Needle↗
PubMed2001

[A diabetes care team--role of diabetes specialists and certified diabetes educator].

In recent decades, diabetes care has undergone fundamental changes that have influenced the manner in which any type of diabetic patients are managed: (i) acceptance of tight metabolic control; (ii) recognition of primary care management; (iii) focus on quality improvement: and (iv) emphasis on cost containment. Then, the role of a diabetes care team has been recognized and acted upon to a far greater extent than before. Treatment of diabetes consists of two principal components: metabolic control and intervention to prevent complications. The former is a part of the primary health care scheme in which the indication for education, as well as care and treatment, frequently depend of the data produced by patients; the latter pertaining to hospital-based care. In 2001 in Japan, the number of the diabetes specialists is about 2500, and the certified diabetes educators certified are about 4300. However, the accessibility of the patients to the specialists still remains poor. Nurses, dietitians, medical technologists, pharmacists and physical therapists are eligible to take the examination of certified diabetes educator. They must be skilled at identifying the background of patients to improve care and health through life-style modification. Education for care and treatment consists of medical and educational models. In both of these, here are specific processes of diagnosis and therapy: along with medical diagnosis and treatment, through physical and laboratory examinations, assessment of the patient for indication of a curriculum by test of knowledge, skill and attitude for adequate educational therapy is necessary.

Certification↗
PubMed2000

Best practices for the prevention, diagnosis, and treatment of diabetic foot ulcers.

Although the prevention, assessment, and treatment of diabetic foot ulcers has improved in recent years, care is often fragmented and does not always meet best clinical practice. This article incorporates current best clinical practices and expert opinion with available research to arrive at 11 recommendations. These recommendations include adequate vascular supply, infection control, pressure offloading, and an optimal local wound environment. This approach is best accomplished through a multidisciplinary team and revolves around the active participation of the person with diabetes. The authors' intent is to provide a practical, easy-to-follow guide to allow healthcare professionals to establish and empower a team to provide best clinical practices.

Algorithms↗
PubMed2001

Cutaneous malignant melanoma.

Melanoma is the deadliest form of skin cancer; 47,700 persons were expected to be diagnosed and 9,600 were expected to die from melanoma in 2000 (American Cancer Society, 2000). It is important for dermatology nurses to understand the epidemiology, risk factors, clinical presentation, diagnosis, treatment, prognosis, and prevention of cutaneous malignant melanoma.

Humans↗
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Benchmarking↗