Trephine Minimally Invasive Procedure for Pilonidal Sinus.

BACKGROUND: Pilonidal sinus is a chronic, inflammatory condition. Controversy exists regarding the best surgical management for pilonidal sinus, including the extent of excision and type of closure of the surgical wound. OBJECTIVES: To assess the short- and long-term outcomes and success rate of the trephine procedure for the treatment of pilonidal sinus. METHODS: A retrospective observational cohort study was conducted at a single center. Patients who underwent trephine procedure between 2011 and 2015 were included. Data collection included medical records review and a telephone interview to establish long-term follow-up. RESULTS: A total of 169 patients underwent the trephine technique for the repair of pilonidal sinus. Follow-up included 113 patients, median age 20 years. Initial postoperative period, 35.6% recalled no pain and 58.6% reported a mild to moderate pain. Postoperative complications included local infection (7.5%) and mild bleeding (15.1%). On early postoperative follow-up, 47.1% recalled no impairment in quality of life, and 25%, 21.2 %, and 6.7% had mild, moderate and sever disturbance respectively. The median time to return to work or school was 10 days. At a median follow-up of 29 months (IQR 19-40), recurrence rate was 45.1% (51/113), and 38 (33.9%) of the patients underwent another surgical procedure Overweight, smoking, and family history were associated with higher recurrence rate. CONCLUSIONS: The trephines technique has a significant long-term recurrence rate. Short-term advantages include low morbidity, enhanced recovery, and minimal to mild postoperative impairment to quality of life. The trephine procedure may be justified as a first treatment of pilonidal disease.

The contribution of self-efficacy, social support and participation in the community to predicting loneliness among persons with schizophrenia living in supported residences.

UNLABELLED: The purpose of this study was to examine the contribution of self-efficacy, social support, social participation, living arrangement, and employment status to predicting loneliness among 97 individuals (over age 18) who were diagnosed with schizophrenia and lived in supported residences within the community. METHOD: Participants responded to five self-report questionnaires: a socio-demographic questionnaire, the UCLA Loneliness Scale, the General Self-Efficacy Scale, the MOS Social Support Survey, and the Participation and Use of Services in the Community Questionnaire. RESULTS: Social support, participation in the community, and living arrangement emerged as significant predictors of loneliness: the higher the participants' levels of social support and participation in leisure and social activities in the community, the lower their levels of loneliness. In addition to these findings, participants living in semi-independent and independent apartments felt lonelier and reported higher levels of social support and social participation in the community than their counterparts living in group homes. Practical implications for mental health professionals and caretakers are discussed.

Contribution of demographic, medical, and social support variables in predicting the mental health dimension of quality of life among people with multiple sclerosis.

The purpose of this study was to examine the contribution of demographic, medical, and social support variables in predicting the mental health dimension of quality of life (MHD/QOL) among people with multiple sclerosis (MS). Eighty-two participants of employment age recruited from hospital neurology clinics specializing in MS completed a demographic questionnaire, and 69 completed the Multiple Sclerosis Quality of Life Inventory (MSQLI). In addition, a neurologist used the Expanded Disability Status Scale (EDSS) to assess the medical status of each participant.The number of young children in the family, MS duration, cognitive impairment, and social support were predictors of MHD/QOL. Employment was not associated with MHD/QOL score. Social support made a significant and unique contribution to the MHD/QOL beyond all the other variables. Implications for social work practice are presented.

Parents of mentally ill adult children living at home: rewards of caregiving.

In the context of parents caring at home for an adult child with mental illness, this study explored the positive aspects and rewards of caregiving. Specifically, it measured the extent to which parents perceive their ill child as providing assistance and support--practical and emotional--and perceive their own caregiving as emotionally and mentally rewarding. One parent from each of 93 households completed a self-administered questionnaire. All the parents reported receiving help and support from their child, but perceived the satisfaction gained from fulfilling their parental duties and from learning about themselves as far more important. Their assessment of this satisfaction was entirely unaffected by the subjective and objective burdens on them and the severity of the child's illness.