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General surgery

Monica Chahal-Kummen, Trond-Eirik Strand, Jan Ove Owe, Eigil Gulliksen, Anthony S Wagstaff
BACKGROUND: A candidate with paraplegia contacted the Institute of Aviation Medicine, Oslo, requesting a medical examination and medical certification for flying back seat on an F-16 Fighting Falcon. Thorough aeromedical examinations, including specialist evaluations, were initiated for the final decision to be made. CASE REPORT: Almost 13 yr earlier the candidate had acquired spinal cord damage at neurological level L1 after falling 4 m (13 ft) from out of a window...
2016: Aerospace Medicine and Human Performance
Paula Ferrada, Rao R Ivatury, David A Spain, Kimberly A Davis, Michel Aboutanos, John J Fildes, Thomas M Scalea
INTRODUCTION: Acute Care Surgery (ACS), Trauma and Surgical Critical Care (SCC) fellowships graduate fellows deemed qualified to perform complex cases immediately upon graduation. We hypothesize international fellow rotations (IFR) can be a resource to supplement operative case exposure METHODS: A survey was sent to all program directors of ACS and SCC fellowships via email. Data was captured and analyzed using the Research Electronic Data Capture (REDCap) tool. RESULTS: The survey was sent to 113 program directors (PDs) with a response rate of 42%...
October 25, 2016: Journal of Trauma and Acute Care Surgery
James E Coverdill, Adnan Alseidi, David C Borgstrom, Daniel L Dent, Russell D Dumire, Jonathan Fryer, Thomas H Hartranft, Steven B Holsten, M Timothy Nelson, Mohsen Shabahang, Stanley Sherman, Paula M Termuhlen, Randy J Woods, John D Mellinger
PURPOSE: Duty hours rules sparked debates about professionalism. This study explores whether and why general surgery residents delay departures at the end of a day shift in ways consistent with shift work, traditional professionalism, or a new professionalism. METHOD: Questionnaires were administered to categorical residents in 13 general surgery programs in 2014 and 2015. The response rate was 76% (N = 291). The 18 items focused on end-of-shift behaviors and the frequency and source of delayed departures...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Sara H Javid, Sarah O Lawrence, Danielle C Lavallee
Breast-cancer-specific tools that measure health-related quality of life (HRQOL) were developed for use in research or clinical practice, and little is known about these tools' performance ability for quality improvement. Furthermore, existing tools may not fully reflect all issues that contribute to quality care as seen by patients. Work is needed to identify and validate patient-reported outcome measures for use in quality improvement in breast cancer surgical care. We conducted an exploratory qualitative study in order to better understand what HRQOL domains and processes of care define high quality surgical care for women undergoing mastectomy for breast cancer from both the patient and clinician perspective...
October 25, 2016: Breast Journal
Ali Abdel Raheem, Atalla Alatawi, Dae Keun Kim, Abulhasan Sheikh, Koon Ho Rha
INTRODUCTION AND OBJECTIVES: Nephroureterectomy remains the gold standard treatment option for upper tract tumors. However, segmental ureterectomy may be another option in patients with single kidney, borderline renal function or high medical comorbidities. The aim of this video is to assess the feasibility of robotic surgery as a minimally invasive technique in treatment of a high comorbid patient with ureteric tumor. MATERIALS AND METHODS: Eighty-year old male patient, with a medical history of chronic hypertensive and uncontrolled Diabetes Mellitus, was referred to our department for treatment of ureteric tumor...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
October 24, 2016: Der Anaesthesist
Kim J Brolin Ribacke, Dell D Saulnier, Anneli Eriksson, Johan von Schreeb
Significant efforts were invested in halting the recent Ebola virus disease outbreak in West Africa. Now, studies are emerging on the magnitude of the indirect health effects of the outbreak in the affected countries, and the aim of this study is to systematically assess the results of these publications. The methodology for this review adhered to the Prisma guidelines for systematic reviews. A total of 3354 articles were identified for screening, and while 117 articles were read in full, 22 studies were included in the final review...
2016: Frontiers in Public Health
Jeong-Min Hong, Eunsoo Kim, Hae-Kyu Kim, Do-Won Lee, Ji-Seok Baik, Ji-Youn Lee
INTRODUCTION: Interstitial lung disease (ILD), which is the most common form of respiratory involvement of Sjȍgren syndrome (SS), is highly associated with postoperative pulmonary complications after surgery. We report the successful anesthetic management of a cervical cancer patient with SS and ILD under combined spinal-epidural anesthesia (CSE) to avoid postoperative pulmonary complications. CASE DESCRIPTION: A 41-year-old woman with SS complicated by recently progressive ILD was scheduled for an elective radical hysterectomy under the diagnosis of cervical cancer...
2016: SpringerPlus
Anna Jungwirth-Weinberger, Paul Borbas, Andreas Schweizer, Ladislav Nagy
Purpose Ulna-shortening osteotomy is one of the most established and most frequent operations in hand surgery. However, bone union is not always achieved and the use of plates implies potential risks and problems. The traditional points of criticism are the duration of bone healing, the incidence of nonunion, and the necessity of hardware removal due to the soft tissue irritation by the plate or the screws. These shortcomings have been addressed by an increasing standardization of the procedure and finally specific instruments and implants...
November 2016: Journal of Wrist Surgery
Danielle M Raves, Alexandra Brewis, Sarah Trainer, Seung-Yong Han, Amber Wutich
Background: Weight-related stigma is reported frequently by higher body-weight patients in healthcare settings. Bariatric surgery triggers profound weight loss. This weight loss may therefore alleviate patients' experiences of weight-related stigma within healthcare settings. In non-clinical settings, weight-related stigma is associated with weight-inducing eating patterns. Dietary adherence is a major challenge after bariatric surgery. Objectives: (1) Evaluate the relationship between weight-related stigma and post-surgical dietary adherence; (2) understand if weight loss reduces weight-related stigma, thereby improving post-surgical dietary adherence; and (3) explore provider and patient perspectives on adherence and stigma in healthcare settings...
2016: Frontiers in Psychology
Hai-da Shi, Xian-Jie Shi, Shao-Cheng Lv, Huan-Xian Ma, Yu-Rong Liang, Lin Zhou, Yong Shi
OBJECTIVE: To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases. METHODS: We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point...
October 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Sameera Khan, Reza Hamedy, Yuejuan Lei, Rikke S Ogawa, Shane N White
INTRODUCTION: Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes. Dental anxiety has been associated with pain, fear, care avoidance, and more invasive treatments including nonsurgical root canal treatment (NSRCT). The very words root canal are deeply embedded in societal consciousness. Better understanding of dental anxiety may prevent treatment avoidance. The purpose of this study was to conduct a systematic review of NSRCT-associated anxiety...
October 21, 2016: Journal of Endodontics
Dennis Grech, Zhifeng Li, Patrick Morcillo, Evelyne Kalyoussef, David D Kim, Alex Bekker, Luis Ulloa
Neuronal stimulation improves physiological responses to infection and trauma, but the clinical potential of this strategy is unknown. We hypothesized that transdermal neural stimulation through low-frequency electroacupuncture might control the immune responses to surgical trauma and expedite the postoperative recovery. However, the efficiency of electroacupuncture is questioned due to the placebo effect. Here, electroacupuncture was performed on anesthetized patients to avoid any placebo. This is a prospective double-blinded pilot trial to determine whether intraoperative electroacupuncture on anesthetized patients improves postoperative recovery...
October 2016: Journal of Acupuncture and Meridian Studies
C Steiner, M P Steurer, D Mueller, M Zueger, A Dullenkopf
BACKGROUND: Midazolam is commonly used as a pre-anesthesia anxiolytic. It`s elimination may not be fast enough for short procedures. In orally premedicated patients we obtained midazolam plasma concentrations at the end of surgical procedures and compared those to concentrations at anesthesia induction. METHODS: The study was conducted prospectively with consent of the local ethics committee (Ethikkomission Kanton Thurgau, Switzerland) and carried out with written informed consent of each patient...
October 24, 2016: BMC Anesthesiology
Florent L Besson, Paul Blanc-Durand, Céline Meyer, Gilles Grimon, Emmanuel Durand
Eumycetoma is a chronic tropical fungal disease that infiltrates subcutaneous tissues, mainly in the feet and legs. Standard antifungal drugs are ineffective, and mutilating surgery is common. Morphological imaging is useful for assessing the local extent of the disease before surgery. FDG PET/CT may be of potential interest for the general extent, but PET descriptions remain scarce and mostly relate to the feet. Here, the authors present FDG PET/CT and MRI study of a very rare case of an extensive, biopsy-proven eumycetoma of the right thigh that was performed to guide potential surgery...
October 21, 2016: Clinical Nuclear Medicine
Nancy M Heddle, Richard J Cook, Donald M Arnold, Yang Liu, Rebecca Barty, Mark A Crowther, P J Devereaux, Jack Hirsh, Theodore E Warkentin, Kathryn E Webert, David Roxby, Magdalena Sobieraj-Teague, Andrea Kurz, Daniel I Sessler, Priscilla Figueroa, Martin Ellis, John W Eikelboom
Background Randomized, controlled trials have suggested that the transfusion of blood after prolonged storage does not increase the risk of adverse outcomes among patients, although most of these trials were restricted to high-risk populations and were not powered to detect small but clinically important differences in mortality. We sought to find out whether the duration of blood storage would have an effect on mortality after transfusion in a general population of hospitalized patients. Methods In this pragmatic, randomized, controlled trial conducted at six hospitals in four countries, we randomly assigned patients who required a red-cell transfusion to receive blood that had been stored for the shortest duration (short-term storage group) or the longest duration (long-term storage group) in a 1:2 ratio...
October 24, 2016: New England Journal of Medicine
Caleb Mpyet, Nasiru Muhammad, Mohammed Dantani Adamu, Habila Muazu, Murtala Mohammad Umar, Musa Goyol, Uwazoeke Onyebuchi, Ima Chima, Haliru Idris, Adamani William, Sunday Isiyaku, Benjamin Nwobi, Rebecca Mann Flueckiger, Rebecca Willis, Alexandre Pavluck, Brian K Chu, Nicholas Olobio, Anthony W Solomon
PURPOSE: To determine the local government area (LGA)-level prevalence of trachoma in all 34 LGAs of Katsina State. METHODS: A population-based prevalence survey was conducted in each LGA of Katsina State, using the Global Trachoma Mapping Project methodology. We used a 3-stage cluster random sampling strategy to select 25 households from each of 25 clusters. We examined all residents of selected households aged 1 year and older for the clinical signs of trachomatous inflammation-follicular (TF), trachomatous inflammation-intense and trichiasis, using the World Health Organization (WHO) simplified grading scheme...
October 24, 2016: Ophthalmic Epidemiology
B Estors Sastre, P Bragagnini Rodríguez, R Fernández Atuan, R Delgado Alvira, M A Rihuete Heras, J Gracia Romero
AIM OF THE STUDY: To investigate the association between endocrine disrupting chemicals (EDC) exposure and other paternal factors in the etiology of hipospadias and cryptorchidism. METHODS: A case-control study. Cases were infants between 0 and 6 years of age diagnosed with hypospadias or cryptorchidism in our pediatric urology and general pediatric surgery services during a period of 6 months, and controls were infants with the same range of age attending the same services without any urological problem...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
M M F Aubuchon, L J J Bolt, M L G Janssen-Heijnen, S T H P Verleisdonk-Bolhaar, A van Marion, C L H van Berlo
BACKGROUND: Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained. METHODS: Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed...
October 23, 2016: Acta Chirurgica Belgica
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