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https://www.readbyqxmd.com/read/28351068/what-attitudes-and-values-are-incorporated-into-self-as-part-of-professional-identity-construction-when-becoming-a-surgeon
#1
Alexandra Cope, Jeff Bezemer, Stella Mavroveli, Roger Kneebone
PURPOSE: To make explicit the attitudes and values of a community of surgeons, with the aim of understanding professional identity construction within a specific group of residents. METHOD: Using a grounded theory method, the authors collected data from 16 postgraduate surgeons through interviews. They complemented these initial interview data with ethnographic observations and additional descriptive interviews to explore the attitudes and values learned by surgeons during residency training (2010-2013)...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28350974/topical-hemostasis-in-laparoscopic-surgery
#2
REVIEW
R Vecchio, R Catalano, F Basile, C Spataro, M Caputo, E Intagliata
A major goal during any surgical intervention is minimization of blood loss, which reduces the need for blood transfusion. In open surgery, the possibility for the surgeon to use the hands directly in contact with the bleeding tissues for hemostasis, makes mechanical methods, such as compression, ligatures or sutures, important to achieve proper hemostasis. In laparoscopic surgery, where the intervention is performed by means of small incisions through which the surgeon's hand cannot directly achieve the tissues, the problem of hemostasis is critical and needs more attention...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#3
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350944/navigation-and-robotics-in-spinal-surgery-where-are-we-now
#4
Samuel C Overley, Samuel K Cho, Ankit I Mehta, Paul M Arnold
Spine surgery has experienced much technological innovation over the past several decades. The field has seen advancements in operative techniques, implants and biologics, and equipment such as computer-assisted navigation and surgical robotics. With the arrival of real-time image guidance and navigation capabilities along with the computing ability to process and reconstruct these data into an interactive three-dimensional spinal "map", so too have the applications of surgical robotic technology. While spinal robotics and navigation represent promising potential for improving modern spinal surgery, it remains paramount to demonstrate its superiority as compared to traditional techniques prior to assimilation of its use amongst surgeons...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350941/spine-oncology-primary-spine-tumors
#5
Nicolas Dea, Ziya Gokaslan, David Choi, Charles Fisher
Primary tumors originating from the spine are very complex and challenging entities to treat. Due to their rarity, a multicenter collaborative network is essential to shepherd the best research and contribute to the dissemination of the best evidence possible. Over the last few years, several advances have occurred in many different fields. Surgery is still the cornerstone of treatment in most cases. The occasional suboptimal outcomes and high morbidity of surgical treatment have however encouraged professionals caring for these patients to explore safer treatment options and alternatives or adjuncts to surgical treatment...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350928/effect-of-total-laparoscopic-hysterectomy-vs-total-abdominal-hysterectomy-on-disease-free-survival-among-women-with-stage-i-endometrial-cancer-a-randomized-clinical-trial
#6
Monika Janda, Val Gebski, Lucy C Davies, Peta Forder, Alison Brand, Russell Hogg, Thomas W Jobling, Russell Land, Tom Manolitsas, Marcelo Nascimento, Deborah Neesham, James L Nicklin, Martin K Oehler, Geoff Otton, Lewis Perrin, Stuart Salfinger, Ian Hammond, Yee Leung, Peter Sykes, Hextan Ngan, Andrea Garrett, Michael Laney, Tong Yow Ng, Karfai Tam, Karen Chan, C David Wrede, Selvan Pather, Bryony Simcock, Rhonda Farrell, Gregory Robertson, Graeme Walker, Nigel R Armfield, Nick Graves, Anthony J McCartney, Andreas Obermair
Importance: Standard treatment for endometrial cancer involves removal of the uterus, tubes, ovaries, and lymph nodes. Few randomized trials have compared disease-free survival outcomes for surgical approaches. Objective: To investigate whether total laparoscopic hysterectomy (TLH) is equivalent to total abdominal hysterectomy (TAH) in women with treatment-naive endometrial cancer. Design, Setting, and Participants: The Laparoscopic Approach to Cancer of the Endometrium (LACE) trial was a multinational, randomized equivalence trial conducted between October 7, 2005, and June 30, 2010, in which 27 surgeons from 20 tertiary gynecological cancer centers in Australia, New Zealand, and Hong Kong randomized 760 women with stage I endometrioid endometrial cancer to either TLH or TAH...
March 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28350886/parathyroid-score-can-predict-the-duration-of-required-calcium-supplementation-after-total-thyroidectomy
#7
Bup-Woo Kim, Soo Young Kim, Yong Sang Lee, Seok-Mo Kim, Hang-Seok Chang, Cheong Soo Park
BACKGROUND: Postoperative hypoparathyroidism is the most common complication after total thyroidectomy, owing to unintentional injury or decreased blood flow to the parathyroid glands. Prediction of postoperative hypoparathyroidism would be helpful for surgeons to manage postoperative hypocalcemia. In this study, we scored the discoloration of the parathyroid glands using a new parathyroid scoring system and evaluated the correlation between the parathyroid score and duration of required calcium supplementation after total thyroidectomy...
2017: PloS One
https://www.readbyqxmd.com/read/28350730/pas-in-orthopedics-in-the-vha-s-community-based-outpatient-clinics
#8
Daniel O Reed, Roderick S Hooker
In the Veterans Health Administration (VHA) system, most orthopedic care takes place in the VA medical centers (VAMCs). Because most patients receiving orthopedic care were referred by adult medicine providers, more widely deploying physician assistants (PAs) in orthopedic medicine might help offset this workload. An orthopedic medicine demonstration project recruited, trained, and positioned PAs in community-based outpatient clinics (CBOCs) to improve access to care. The project involved surgeons at the Houston VAMC instructing five newly employed PAs in a wide range of orthopedic evaluation and management strategies before their assignment to a CBOC...
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28350681/evolution-of-a-surgical-philosophy-in-orthognathic-surgery
#9
Harvey M Rosen
A surgical philosophy of orthognathic surgery is presented. It has evolved over an entire surgical career as orthognathic surgical goals have evolved to become primarily aesthetic. In this context, the occlusal result serves as a means of achieving the aesthetic ends. It relies on the physical examination, using qualitative concepts of facial appearance, to be the most important determinant of treatment plans. It makes a distinction between a quantitatively normal face and one that is visually well proportioned and emphasizes the attributes of the soft tissue...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350680/airway-and-feeding-outcomes-of-mandibular-distraction-tongue-lip-adhesion-and-conservative-management-in-pierre-robin-sequence-a-prospective-study
#10
Ibrahim Khansa, Courtney Hall, Lauren L Madhoun, Mark Splaingard, Adriane Baylis, Richard E Kirschner, Gregory D Pearson
BACKGROUND: Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350679/frontal-sinus-volume-and-frontal-bar-position-are-associated-in-unicoronal-craniosynostosis
#11
Wen Xu, Patrick A Gerety, Jing Li, Scott P Bartlett, Jesse A Taylor
BACKGROUND: Frontal sinus pneumatization plays an important role in brow protrusion, and absence of frontal sinus development may be associated with brow retrusion. Using unicoronal craniosynostosis as a model, the authors studied the relationship among frontal sinus volume, supraorbital retrusion, and brow position. METHODS: The authors conducted a retrospective review of unicoronal craniosynostosis patients with head computed tomographic scans and photographs taken from ages 5 to 18 years...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350676/comparison-of-the-outcomes-of-complex-orbital-fracture-repair-with-and-without-a-surgical-navigation-system-a-prospective-cohort-study-with-historical-controls
#12
Emanuele Zavattero, Guglielmo Ramieri, Fabio Roccia, Giovanni Gerbino
BACKGROUND: In severe orbital fractures, restoration of orbital shape and volume is required to avoid diplopia and posttraumatic enophthalmos. The purpose of this study was to compare outcomes between navigation-aided and conventional techniques for complex unilateral orbital fractures using titanium mesh. METHODS: The outcomes and the computed tomography-measured orbital volume of two groups of orbital complex unilateral reconstruction cases were compared. The study group consisted of a consecutive cohort of unilateral severe orbital fracture that underwent surgery with the aid of a Brainlab navigation system...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350675/early-distraction-for-mild-to-moderate-unilateral-craniofacial-microsomia-long-term-follow-up-outcomes-and-recommendations
#13
Katie E Weichman, Jordan Jacobs, Parit Patel, Caroline Szpalski, Pradip Shetye, Barry Grayson, Joseph G McCarthy
BACKGROUND: There is controversy regarding the treatment of young patients with unilateral craniofacial microsomia and moderate dysmorphism. The relative indication for mandibular distraction in such patients poses several questions: Is it deleterious in the context of craniofacial growth and appearance? This study was designed to address these questions. METHODS: A retrospective review of patients undergoing mandibular distraction by a single surgeon between 1989 and 2010 was conducted...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350658/top-surgery-in-transgender-men-how-far-can-you-push-the-envelope
#14
Rachel Bluebond-Langner, Jens U Berli, Jennifer Sabino, Karan Chopra, Devinder Singh, Beverly Fischer
BACKGROUND: The authors present their grading scale and the outcomes of the largest cohort of top surgery published to date. Application of this grading system can help determine which patients will benefit from a subcutaneous mastectomy with free nipple graft versus a circumareolar technique, with the primary endpoint being need for aesthetic revisions. METHODS: The authors reviewed their database of transgender males who underwent bilateral mastectomy between 2006 and 2015...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350654/a-prospective-randomized-trial-of-the-efficacy-of-fibrin-glue-triamcinolone-acetonide-and-quilting-sutures-in-seroma-prevention-after-latissimus-dorsi-breast-reconstruction
#15
Alexandra M Hart, Clarie Duggal, Ximena Pinell-White, Albert Losken
BACKGROUND: Donor-site seroma is the most common complication following latissimus dorsi flap breast reconstruction. Various agents and techniques have attempted to minimize seroma formation. The purpose of this study was to compare the efficacy of different products and quilting sutures at seroma prevention. METHODS: This is a single-center, double-blinded, randomized, controlled trial of a consecutive series of breast cancer patients (n = 96) undergoing latissimus dorsi flap reconstruction performed by a single surgeon...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28350568/reducing-length-of-stay-using-a-robotic-assisted-approach-for-retromuscular-ventral-hernia-repair-a-comparative-analysis-from-the-americas-hernia-society-quality-collaborative
#16
Alfredo M Carbonell, Jeremy A Warren, Ajita S Prabhu, Conrad D Ballecer, Randy J Janczyk, Javier Herrera, Li-Ching Huang, Sharon Phillips, Michael J Rosen, Benjamin K Poulose
OBJECTIVE: The aim of this study was to compare length of stay (LOS) after robotic-assisted and open retromuscular ventral hernia repair (RVHR). BACKGROUND: RVHR has traditionally been performed by open techniques. Robotic-assisted surgery enables surgeons to perform minimally invasive RVHR, but with unknown benefit. Using real-world evidence, this study compared LOS after open (o-RVHR) and robotic-assisted (r-RVHR) approach. METHODS: Multi-institutional data from patients undergoing elective RVHR in the Americas Hernia Society Quality Collaborative between 2013 and 2016 were analyzed...
March 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28350557/double-versus-single-tendon-transfers-to-improve-shoulder-function-in-brachial-plexus-birth-palsy
#17
Dustin A Greenhill, William R Smith, F V Ramsey, Scott H Kozin, Dan A Zlotolow
BACKGROUND: In children with brachial plexus birth palsy (BPBP) undergoing tendon transfers to augment shoulder external rotation, it is unclear whether transfer of the latissimus dorsi with its combined latissimus dorsi and teres major (cLT) versus isolated teres major (iTM) tendon transfer yield different outcomes. METHODS: Records of patients with BPBP who underwent shoulder tendon transfers to augment external rotation were retrospectively reviewed. Transfer type (cLT or iTM) was considered indiscriminate by virtue of surgeon preference...
March 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28346770/a-core-outcome-set-for-localised-prostate-cancer-effectiveness-trials
#18
Steven MacLennan, Paula R Williamson, Hanneke Bekema, Marion Campbell, Craig Ramsay, James N'Dow, Sara MacLennan, Luke Vale, Philipp Dahm, Nicolas Mottet, Thomas Lam, Paul Abel, Hashim U Ahmed, Gary Akehurst, Robert Almquist, Karl Beck, David Budd, Steven Canfield, James Catto, Philip Cornford, William Cross, Alexander Ewen, Judith Grant, Rakesh Heer, David Hurst, Rob Jones, Roger Kockelbergh, Andrew Mackie, Graham MacDonald, Alan McNeill, Malcolm Mason, Sam McClinton, Duncan McLaren, Hugh Mostafid, Ian Pearce, Linda Pennet, Justine Royle, Hans Schreuder, Grant D Stewart, Henk van der Poel, Kevin Wardlaw, Thomas Wiegel
OBJECTIVE: To develop a core outcome set (COS) applicable for effectiveness trials of all interventions for localised prostate cancer. BACKGROUND: Many treatments exist for localised prostate cancer, although it is unclear which offers the optimal therapeutic ratio. This is confounded by inconsistencies in the selection, definition, measurement and reporting of outcomes in clinical trials. SUBJECTS AND METHODS: A list of 79 outcomes was derived from a systematic review of published localised prostate cancer effectiveness studies and semi-structured interviews with 15 prostate cancer patients...
March 27, 2017: BJU International
https://www.readbyqxmd.com/read/28346311/latissimus-dorsi-flap-breast-reconstruction-a-nationwide-inpatient-sample-review
#19
Michael R DeLong, Vickram J Tandon, George H Rudkin, Andrew L Da Lio
INTRODUCTION: The latissimus dorsi (LD) myocutaneous flap has been a long term standard for breast reconstruction. The variable indications for the LD flap have not been statistically examined because of the relative infrequency of its use by any single surgeon or institution. METHODS: The Nationwide Inpatient Sample data set was queried for all patient encounters involving a LD myocutaneous flap procedure. The study population was further restricted to female patients with a history of breast cancer or previous mastectomy...
March 24, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28346291/round-and-oval-window-anatomic-variability-its-implication-for-the-vibroplasty-technique
#20
Marta Mancheño, Miguel Aristegui, Jose Ramon Sañudo
OBJECTIVE: The objective of this study is to evaluate the anatomical variability of round and oval window regions and its relationship with their closest structures, to determine its implication on the fitting and stabilization of the middle ear implant Vibrant Soundbridge. METHODS: Variations of the anatomy of round and oval window regions were assessed in a total of 85 human dissected temporal bones. Afterward, we evaluated the adaptation and subsequent stabilization of the floating mass transducer (FMT) of the Vibrant Soundbridge in 67 cases in round window (RW) and in 22 cases in oval window (OW), and the influence that the variability of the different anatomical features examined had on this stabilization...
March 24, 2017: Otology & Neurotology
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