PubMed · 15406526
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T G BLOCKER, J MITHOEFER. 1950. The pattern flap.. https://doi.org/10.1097/00006534-195002000-00006
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The optimal strategy for follow-up of extremity soft tissue sarcoma patients after primary treatment with curative intent is not known. The 1592 members of the Society of Surgical Oncology (SSO) were sent a survey to determine their practices. Office visits and chest X-rays were the most frequently performed items for all years. Complete blood count and liver function tests were the most commonly ordered blood tests, but many respondents did not order any blood tests routinely. Imaging studies of the extremities were recommended for most patients during the first postoperative year. Postoperative surveillance strategies after sarcoma treatment vary appreciably among surgeons. Surgeon age, tumor size, tumor grade, and geographic location of the surgeon account for only a modest amount of the variation, suggesting that lack of evidence supporting any particular strategy is the factor responsible for most of the variation. Efforts to provide high-quality evidence on this topic are warranted.
Previous research has demonstrated that people's movements can become unintentionally coordinated during interpersonal interaction. The current study sought to uncover the degree to which visual and verbal (conversation) interaction constrains and organizes the rhythmic limb movements of coactors. Two experiments were conducted in which pairs of participants completed an interpersonal puzzle task while swinging handheld pendulums with instructions that minimized intentional coordination but facilitated either visual or verbal interaction. Cross-spectral analysis revealed a higher degree of coordination for conditions in which the pairs were visually coupled. In contrast, verbal interaction alone was not found to provide a sufficient medium for unintentional coordination to occur, nor did it enhance the unintentional coordination that emerged during visual interaction. The results raise questions concerning differences between visual and verbal informational linkages during interaction and how these differences may affect interpersonal movement production and its coordination.
In cases of extended post-traumatic soft-tissue and bone loss as well as with mutilating infection or radical tumor resection, multidisciplinary options are required to salvage extremities and functional rehabilitation. A surgical team approach allows for reduction of amputation rates, wound healing complications, and secondary procedures in limb oncology and trauma. The goals and limitations of cooperative surgical concepts are described. In the future, continuing medical education will focus not only on indications and techniques but also on complication management, medicolegal problems, and economic deficits due to maladapted legal structures. Provided clear clinical pathways are introduced to guide indications, surgical procedures, and postoperative treatment, marked financial deficits may be avoided. While, in the past, responsibility for the patient and ethical considerations resulted in the development of voluntary interdisciplinary treatment programs, economic strategies and an increasing number of malpractice suits in the future will inevitably produce new imperatives for interdisciplinary cooperation.