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Surgical ethics

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https://www.readbyqxmd.com/read/28228966/objective-image-analysis-of-real-time-three-dimensional-intraoperative-ultrasound-for-intrinsic-brain-tumour-surgery
#1
Sophie J Camp, Vasileios Apostolopoulos, Vasileios Raptopoulos, Amrish Mehta, Kevin O'Neill, Mohammed Awad, Babar Vaqas, David Peterson, Federico Roncaroli, Dipankar Nandi
BACKGROUND: There is growing evidence that maximal surgical resection of primary intrinsic brain tumours is beneficial, both by improving progression free and overall survival and also by facilitating postoperative chemotherapy and radiotherapy. Hence, there has been an increase in the popularity of real-time intraoperative imaging in brain tumour surgery. The complex theatre arrangements, prohibitive cost and prolonged theatre time of intraoperative MRI have restricted its application...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28218554/the-scandcleft-randomised-trials-of-primary-surgery-for-unilateral-cleft-lip-and-palate-11-what-next
#2
William Shaw, Gunvor Semb
BACKGROUND AND AIMS: Longstanding uncertainty surrounds the selection of surgical protocols for unilateral cleft lip and palate (UCLP), and randomised trials have only occasionally been performed. The Scandcleft Project consists of three trials initiated in 1997. The results at age 5 have been published in the series of reports that precede this manuscript, which aims to distill some of the issues that future trialists may need to address. METHOD: The shared experience of this group of trials is reviewed with reference to the current literature on trial management and, more specifically, trials of surgical technique and timing...
February 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28218552/scandcleft-randomised-trials-of-primary-surgery-for-unilateral-cleft-lip-and-palate-2-surgical-results
#3
Jorma Rautio, Mikael Andersen, Stig Bolund, Jyri Hukki, Hallvard Vindenes, Peter Davenport, Kjartan Arctander, Ola Larson, Anders Berggren, Frank Åbyholm, David Whitby, Alan Leonard, Jan Lilja, Erik Neovius, Anna Elander, Arja Heliövaara, Phil Eyres, Gunvor Semb
BACKGROUND: Longstanding uncertainty surrounds the selection of surgical protocols for unilateral cleft lip and palate, and randomised trials have only rarely been performed. The Scandcleft Project consists of three trials commenced in 1997 involving ten centres in Denmark, Finland, Norway, Sweden, and the UK. Three groups of centres tested a newly-defined common technique for palatal repair (Arm A) against their local protocols (Arms B, C, D). Arm A was familiar to most of the surgeons in Trial 1, but not to the surgeons in the other Trials...
February 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28218155/perceptions-of-nonsurgical-permanent-contraception-among-potential-users-providers-and-influencers-in-wardha-district-and-new-delhi-india-exploratory-research
#4
Jennifer C Aengst, Elizabeth K Harrington, Pramod Bahulekar, Poonam Shivkumar, Jeffrey T Jensen, B S Garg
BACKGROUND: New permanent contraceptive methods are in development, including nonsurgical permanent contraception (NSPC). OBJECTIVE: In the present study, perceptions of NSPC in India among married women, married men, mothers-in-law, providers, and health advocates in Eastern Maharashtra (Wardha district) and New Delhi were examined. METHODS: We conducted semi-structured interviews with 40 married women and 20 mothers-in-law; surveys with 150 married men; and focus group discussions with obstetrics/gynecology providers and advocates...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28216750/early-results-of-thoraco-lumbar-burst-fracture-treatment-using-selective-corpectomy-and-rectangular-cage-reconstruction
#5
Bowei Liang, Guofeng Huang, Luobing Ding, Liangqi Kang, Mo Sha, Zhenqi Ding
BACKGROUND: Subsidence and late fusion are commonly observed in anterior subtotal corpectomy and reconstruction for treating thoracolumbar burst fractures. The subsidence rate of this surgical method was reported from 19.6% to 75% in the literatures, which would cause treatment failure. Thus, an improvement of anterior surgery technique should be studied to reduce these complications. MATERIALS AND METHODS: 130 patients of thoracolumbar burst fractures treated by minimal corpectomy, decompression and U cage, between January 2009 and December 2010 were included in this study...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28216079/2016-caps-ethics-session-ein-debate-1-regionalization-of-pediatric-surgical-care-2-ethical-introduction-of-surgical-innovation-3-addressing-stress-in-a-surgical-practice-resiliency-well-being-and-burnout
#6
REVIEW
Charles E Bagwell, Priscilla Chiu, Annie Fecteau, Kenneth W Gow, Claudia M Mueller, David Price, Andrew F Zigman
The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2. Innovation in clinical care: ethical considerations, and 3. Surgeon well-being: caring for the caregiver. The authors of this paper, as participants in the debate, were assigned their positions at random...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28213926/association-of-hypercalcemia-before-treatment-with-hypocalcemia-after-treated-in-dogs-with-primary-hyperparathyroidism
#7
J D Dear, P H Kass, A M Della Maggiore, E C Feldman
BACKGROUND: Development of hypocalcemia after treatment of hyperparathyroidism results in increased costs and risk of poorer outcomes. Previous studies have shown conflicting data about predictors of hypocalcemia after these procedures. HYPOTHESIS/OBJECTIVES: The objective of this study was to investigate whether ionized calcium (iCa) concentrations before treatment are predictive of hypocalcemia or its clinical signs after surgical removal or heat ablation in dogs with primary hyperparathyroidism...
February 18, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28211002/factors-that-influence-effective-perioperative-temperature-management-by-anesthesiologists-a-qualitative-study-using-the-theoretical-domains-framework
#8
Sylvain Boet, Andrea M Patey, Justine S Baron, Karim Mohamed, Ashlee-Ann E Pigford, Gregory L Bryson, Jamie C Brehaut, Jeremy M Grimshaw
PURPOSE: Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period. METHODS: After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital...
February 16, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28210847/ethical-considerations-in-the-long-term-ventricular-assist-device-patient
#9
REVIEW
Amanda Cai, Howard J Eisen
PURPOSE OF REVIEW: As the heart failure population continues to age, the need for definitive therapies such as ventricular assist devices (VADs) to extend life and alleviate suffering from end-stage disease directly increases. The goal of this article is to examine the ethical principles of autonomy, beneficence, non-maleficence, and justice within the context of long-term VAD patients. RECENT FINDINGS: Survival rates in VAD-implanted patients have improved in parallel with modernization of device design and surgical technique, reaching that of cardiac transplantation at 1 year post-procedure...
February 16, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28207553/laparoscopic-living-donor-right-hemihepatectomy-with-venous-outflow-reconstruction-using-cadaveric-common-iliac-artery-allograft-case-report-and-literature-review
#10
Jiaxin Li, Jiwei Huang, Hong Wu, Yong Zeng
RATIONALE: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. PATIENT CONCERNS AND DIAGNOSES: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28204962/the-clinical-anatomy-of-the-insertion-of-the-rotator-cuff-tendons
#11
M Vosloo, N Keough, M A De Beer
The rotator cuff (RC) insertions according to most anatomical texts are described as being separate from one another. However, clear fusion of the RC tendon fibres exists with prior studies showing this interdigitation forming a common, continuous insertion onto and around the lesser and greater tubercles (LT and GT) of the humerus. Current surgical repair methods (especially arthroscopic techniques) rarely mention or consider these connections during repair and suture anchor implantation. The general principles of RC surgery remain a controversial subject, due to various available techniques, surgeon experience and preference, and the contradicting success rates...
February 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28203502/effect-of-relaxing-incisions-on-the-maxillary-growth-after-primary-unilateral-cleft-palate-repair-in-mild-and-moderate-cases-a-randomized-clinical-trial
#12
Percy Rossell-Perry, Omar Cotrina-Rabanal, Olga Figallo-Hudtwalcker, Alicia Gonzalez-Vereau
BACKGROUND: The purpose of this study was to evaluate the association between the use of relaxing incisions and maxillary growth disturbance after primary palatoplasty in patients with unilateral cleft lip and palate. METHODS: This is a prospective, randomized, double-blind controlled trial study with ethical committee approval between 2 groups of patients with unilateral cleft lip and palate who were operated on using the two-flap and one-flap techniques from 2008 to 2011...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28202330/ethical-issues-in-cesarean-delivery
#13
REVIEW
Frank A Chervenak, Laurence B McCullough
Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery...
January 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28202005/impact-of-gut-hormone-fgf-19-on-type-2-diabetes-and-mitochondrial-recovery-in-a-prospective-study-of-obese-diabetic-women-undergoing-bariatric-surgery
#14
Lucia Martinez de la Escalera, Ioannis Kyrou, Jana Vrbikova, Voitech Hainer, Petra Sramkova, Martin Fried, Milan K Piya, Sudhesh Kumar, Gyanendra Tripathi, Philip G McTernan
BACKGROUND: The ileal-derived hormone, fibroblast growth factor 19 (FGF-19), may promote weight loss and facilitate type-2 diabetes mellitus remission in bariatric surgical patients. We investigated the effect of different bariatric procedures on circulating FGF-19 levels and the resulting impact on mitochondrial health in white adipose tissue (AT). METHODS: Obese and type-2 diabetic women (n = 39, BMI > 35 kg/m(2)) undergoing either biliopancreatic diversion (BPD), laparoscopic greater curvature plication (LGCP), or laparoscopic adjustable gastric banding (LAGB) participated in this ethics approved study...
February 16, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28192554/using-patient-centered-care-after-a-prenatal-diagnosis-of-trisomy-18-or-trisomy-13-a-review
#15
Shelly Haug, Mitchell Goldstein, Denise Cummins, Elba Fayard, T Allen Merritt
Importance: Patient-centered care (PCC) has been advocated by the Institute of Medicine to improve health care in the United States. Four concepts of PCC align with clinical ethics principles and are associated with enhanced patient/parent satisfaction. These concepts are dignity and respect, information sharing, participation, and collaboration. The objective of this article is to use the PCC approach as a framework for an extensive literature review evaluating the current status of counseling regarding prenatal diagnosis of trisomy 18 (T18) or trisomy 13 (T13) and to advocate PCC in the care of these infants...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28187804/decompressive-craniectomy-in-acute-brain-injury
#16
D A Brown, E F M Wijdicks
Decompressive surgery to reduce pressure under the skull varies from a burrhole, bone flap to removal of a large skull segment. Decompressive craniectomy is the removal of a large enough segment of skull to reduce refractory intracranial pressure and to maintain cerebral compliance for the purpose of preventing neurologic deterioration. Decompressive hemicraniectomy and bifrontal craniectomy are the most commonly performed procedures. Bifrontal craniectomy is most often utilized with generalized cerebral edema in the absence of a focal mass lesion and when there are bilateral frontal contusions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186931/balancing-nurses-workload-in-hospital-wards-study-protocol-of-developing-a-method-to-manage-workload
#17
W F J M van den Oetelaar, H F van Stel, W van Rhenen, R K Stellato, W Grolman
INTRODUCTION: Hospitals pursue different goals at the same time: excellent service to their patients, good quality care, operational excellence, retaining employees. This requires a good balance between patient needs and nursing staff. One way to ensure a proper fit between patient needs and nursing staff is to work with a workload management method. In our view, a nursing workload management method needs to have the following characteristics: easy to interpret; limited additional registration; applicable to different types of hospital wards; supported by nurses; covers all activities of nurses and suitable for prospective planning of nursing staff...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28174394/-past-present-and-future-of-national-clinical-database
#18
Tadashi Iwanaka
The National Clinical Database of Japan( NCD) was established in April 2010 in the collaboration of 9 surgical subspecialty societies on the platform of the Japan Surgical Society(JSS). Registrations began in 2011, and because NCD is strongly linked to the board certification system by JSS, the ratio of registration of surgical procedures is very high, over than 97%. To date, more than 4,000 facilities have enrolled and over 7 million cases were registered over a 5-year period. The analyses of NCD are compared to the foreign database, such as American College of Surgeon National Surgical Quality Improvement Program in the gastrointestinal (GI) surgical field, and the Society of Thoracic Surgeons National Adult Cardiac Database in the cardiovascular surgical field, with a goal of creating a standardized surgery database for quality improvement...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28166482/post-exposure-rabies-prophylaxis-in-humans-exposed-to-animals-in-lublin-province-eastern-poland-in-2012-2015-a-retrospective-study
#19
Joanna Krzowska-Firych, Krzysztof Tomasiewicz, Agata Kozøowska
Rabies continues to be one of the most important viral diseases and remains a significant threat to public health across the globe. The post-exposure prophylaxis in humans can effectively prevent death after exposure to a potentially infected animal. In Poland, recommendations for rabies PEP followed the  national guidelines which recommend that people should receive PEP when bitten by an animal suspected to be infected by rabies. PEP in humans  includes cleansing and disinfecting the wound or point of contact, and administering anti-rabies immunization...
February 6, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28160054/a-simple-method-for-international-standardization-of-photographic-documentation-for-aesthetic-plastic-surgery
#20
Seung Chul Rhee
: Due to the lack of internationally standardized, objective, and scientific photographic standardization methods, differences in photographic documents have gravely affected the truth of surgical outcomes by visual misperception or illusion, thus hindering the development of plastic surgery clinically and scholastically. Here I suggest a simple method for standardization of facial photographs. The method consists of an imaginary transverse line (tentatively the "PSA line") rather than the Frankfort horizontal plane and uses a white background with black grids and standard RGB with CMYK circles...
February 3, 2017: Aesthetic Plastic Surgery
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