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Surgical ethics

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https://www.readbyqxmd.com/read/28105614/-effect-of-surgeons-on-palliative-treatment-for-malignant-tumors
#1
Jin Gu
For advanced stage tumor patients who can not receive radical treatment, quite a part of them require surgical intervention. Surgeons play a important role and are still the main force in palliative treatment for tumors. But in present medical education system, training contents for surgeon involving palliative treatment are few. In fact, surgeons have responsibilities for improving the quality of life, ameliorating pain, preserving the dignity and relieving symptoms of patients in the palliative treatment of tumors...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105531/-big-eye-surgery-the-ethics-of-medicalizing-asian-features
#2
Yves Saint James Aquino
The popularity of surgical modifications of race-typical features among Asian women has generated debates on the ethical implications of the practice. Focusing on blepharoplasty as a representative racial surgery, this article frames the ethical discussion by viewing Asian cosmetic surgery as an example of medicalization, which can be interpreted in two forms: treatment versus enhancement. In the treatment form, medicalization occurs by considering cosmetic surgery as remedy for pathologized Asian features; the pathologization usually occurs in reference to western features as the norm...
January 19, 2017: Theoretical Medicine and Bioethics
https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#3
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28096576/role-of-edaravone-in-managemant-of-septic-peritonitis
#4
Ghada Fouad Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP). MATERIAL AND METHODS: This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28093431/which-is-best-for-osteoporotic-vertebral-compression-fractures-balloon-kyphoplasty-percutaneous-vertebroplasty-or-non-surgical-treatment-a-study-protocol-for-a-bayesian-network-meta-analysis
#5
Shun-Li Kan, Zhi-Fang Yuan, Ling-Xiao Chen, Jing-Cheng Sun, Guang-Zhi Ning, Shi-Qing Feng
INTRODUCTION: Osteoporotic vertebral compression fractures (OVCFs) commonly cause both acute and chronic back pain, substantial spinal deformity, functional disability and decreased quality of life and increase the risk of future vertebral fractures and mortality. Percutaneous vertebroplasty (PVP), balloon kyphoplasty (BK) and non-surgical treatment (NST) are mostly used for the treatment of OVCFs. However, which treatment is preferred is unknown. The purpose of this study is to comprehensively review the literature and ascertain the relative efficacy and safety of BK, PVP and NST for patients with OVCFs using a Bayesian network meta-analysis...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28088244/study-of-the-variability-of-scapular-inclination-and-the-glenoid-version-considerations-for-preoperative-planning-clinical-radiological-study
#6
Petr Fulin, Martin Kysilko, David Pokorny, Radek Padr, Nikola Kasprikova, Ivan Landor, Antonin Sosna
BACKGROUND: Preoperative planning with the aid of imaging methods is a principal factor in successful surgery on the shoulder. This work aims to evaluate the variability of glenoid version, spiralling twist and scapular inclination in relation to the frontal axis. Studies focusing on measuring the variability of scapular inclination in the standardised rest position are lacking in the literature. METHODS: We evaluated 104 CT scans of the shoulder. We measured the glenoid version with respect to the scapular axis at three levels...
January 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28077411/incidence-of-surgical-site-infection-following-caesarean-section-a-systematic-review-and-meta-analysis-protocol
#7
Khalid B M Saeed, Richard A Greene, Paul Corcoran, Sinéad M O'Neill
INTRODUCTION: Caesarean section (CS) rates have increased globally during the past three decades. Surgical site infection (SSI) following CS is a common cause of morbidity with reported rates of 3-15%. SSI represents a substantial burden to the health system including increased length of hospitalisation and costs of postdischarge care. The definition of SSI varies with the postoperative follow-up period among different health systems, resulting in differences in the reporting of SSI incidence...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#8
Victor Bautista-Hernandez, Natalia Cal-Purriños, Jose M Arribas-Leal, Manuel Carnero-Alcazar, Jose F Gutierrez-Diez, Jose J Cuenca-Castillo
INTRODUCTION: Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28070833/assessing-the-accuracy-of-algorithm-derived-cardiorespiratory-fitness-in-surgical-patients-a-prospective-cohort-study
#9
Fadi Hammal, Tanis Quaife, Kieran Purich, Robert Haennel, Ferrante S Gragasin, Daniella San Martin-Feeney, Barry A Finegan
PURPOSE: To determine if a non-exercise algorithm-derived assessment of cardiorespiratory fitness (CRFA) accurately predicted estimated values obtained using a six-minute walk test (CRF6MWD) and the Duke Activity Status Index (CRFDASI). METHODS: Following research ethics board approval, an observational cohort study was conducted in selected, consenting patients undergoing elective surgery. Participants completed questionnaires assessing their self-reported exercise capacity...
January 9, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28070115/proposal-for-a-prospective-registry-for-moyamoya-disease-in-japan
#10
Ken Kazumata, Masaki Ito, Haruto Uchino, Hiroshi Nishihara, Kiyohiro Houkin
The number of clinical research papers published worldwide on moyamoya disease (MMD) has increased recently. However, the majority of the literature comprises retrospective single-center studies collecting data on small numbers of patients. Several multi-center studies are ongoing in Japan; however, the current data are insufficient for comprehensively outlining the various characteristics of MMD. To enhance our knowledge on epidemiologic, vascular, and genetic aspects of MMD, a prospective multicenter registry will be established in Japan that will help to streamline clinical research as well as improve clinical treatments and long-term outcomes...
January 6, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28068382/the-impact-of-pre-operative-breast-mri-on-surgical-waiting-time
#11
Michelle Zhang, Simon Sun, Benoît Mesurolle
PURPOSE: To assess the impact of pre-operative breast MRI on surgical waiting time, and to identify factors contributing to the delay. MATERIALS AND METHODS: A retrospective cohort study involving 1274 patients was conducted after obtaining institutional ethics review. Surgical candidates for newly diagnosed breast cancer from 2007 to 2013 at a tertiary center were divided into 2 groups: those who had pre-operative MRI and those who did not. Linear regression using matched populations was used to compare the surgical waiting times, defined as time from the date of the first positive biopsy to the date of surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28062966/the-existence-of-a-natural-plica-at-the-anatomical-base-of-the-antihelix-and-its-surgical-importance-to-address-protruding-ears-an-anatomicosurgical-study
#12
Miguel Marques Oliveira, Daniel Sousa Marques Oliveira, Gustavo Sousa Marques Oliveira
BACKGROUND: Protruding ears represent the main abnormality of the external ear, which has required numerous anatomic and surgical studies. Most studies give attention to the absence of the antihelix as the anatomic defect responsible for the clinical deformity of the lateral aspect of the ear that leads to its anteversion. The reason for this study is the controversial origin of the fold of the antihelix within the auricle framework, a field of interest for aesthetic otoplasty. The current study examined the medial surface of the cartilaginous ear frame from cadaver specimens with right morphology to investigate the starting point of the fold of the antihelix...
January 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28057652/study-protocol-for-a-randomised-controlled-multicentre-study-the-foraminotomy-acdf-cost-effectiveness-trial-facet-in-patients-with-cervical-radiculopathy
#13
A E H Broekema, J M A Kuijlen, G A T Lesman-Leegte, R H M A Bartels, A D I van Asselt, P C A J Vroomen, J M C van Dijk, M F Reneman, R Soer, R J M Groen
INTRODUCTION: Cervical radiculopathy due to discogenic or spondylotic stenosis of the neuroforamen can be surgically treated by an anterior discectomy with fusion (ACDF) or a posterior foraminotomy (FOR). Most surgeons prefer ACDF, although there are indications that FOR is as effective as ACDF, has a lower complication rate and is less expensive. A head-to-head comparison of the 2 surgical techniques in a randomised controlled trial has not yet been performed. The study objectives of the Foraminotomy ACDF Cost-Effectiveness Trial (FACET) study are to compare clinical outcomes, complication rates and cost-effectiveness of FOR to ACDF...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28054525/questionnaire-survey-to-assess-the-pattern-and-characteristics-of-cell-phone-usage-among-indian-oncologists
#14
Anusheel Munshi, Debanarayan Dutta, Pramod Tike, Jai Prakash Agarwal
PURPOSE: Obtain baseline data of cell-phone usage in the medical (MO), surgical (SO) and radiation (RO) oncology community practicing in India. MATERIALS AND METHODS: Indigenously prepared cell-phone usage related questionnaire was used in the present study after approval by the Institutional Ethics/Scientific Committees. The questionnaire had 41 items and was made to assess the cell-phone usage parameters, utility in clinical practice, awareness, and to compare parameters between oncology specialties...
July 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28051049/non-laparoscopic-minimal-surgical-approach-to-pyloromyotomy-an-experience-from-a-challenged-resource-setting
#15
Ossama M Zakaria
BACKGROUND: The aim of the study is to review the experience with the classic Ramstedt's pyloromyotomy through the RUQ approach and the circumlinear supraumbilical fold approach (circumumbilical [CU]) pyloromyotomy (an approach that combines the ease and safety of the open pyloromyotomy with the advantages of minimal invasiveness). PATIENTS AND METHODS: A single centre review in a period of 12 years from January 2001 to December 2013 with the institutional ethical committee's approval, evaluating 316 pyloromyotomies based on surgical approach: RUQ (171); and CU (145)...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28038484/-the-first-record-of-the-delivery-of-conjoined-twins-in-the-srem-county-in-the-19th-century
#16
Jovan Maksimović, Marko Maksimović
In this paper is presented the first original document of the delivery of conjoined twins on the territory of the present-day Vojvodina. The document number 1224 consists of two handwritten quires. On the first page of the first quire are a description and a drawing of the delivered twins. The delivery was described and drawn by Dr. Ernest Furjaković, a shire physician in Ruma and the secondary physicus of the Srem County, who attended and handled the delivery. The conjoined twins were delivered in the night between 2 and 3 April 1852 in Mali Radinci, a small village in the Srem County nearby Ruma, in the far south of the Habsburg Monarchy...
December 2016: Acta Medico-historica Adriatica: AMHA
https://www.readbyqxmd.com/read/28032849/reflections-on-a-decade-of-face-transplantation
#17
Giorgio Giatsidis, Indranil Sinha, Bohdan Pomahac
On November 27, 2005, Isabelle Dinoire underwent the world's first partial face transplant in Amiens (France) after a dog attack had left her face severely disfigured. The abrupt surgical leap found the medical community and society unprepared to deal with the scientific, ethical, and societal implications of a surgical procedure that was striving to transition from sci-fi novels to science. Today, 10 years and over 35 transplants later, public opinion has become accustomed to the concept of "face restoration" through transplantation...
April 26, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/28025237/responsible-innovation-in-children-s-surgical-care
#18
(no author information available yet)
Advances in medical care may occur when a change in practice incorporates a new treatment or methodology. In surgery, this may involve the translation of a completely novel concept into a new procedure or device or the adaptation of existing treatment approaches or technology to a new clinical application. Regardless of the specifics, innovation should have, as its primary goal, the enhancement of care leading to improved outcomes from the patient's perspective. This policy statement examines innovation as it pertains to surgical care, focusing on some of the definitions that help differentiate applied innovation or innovative therapy from research...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/28005617/lateral-extracavitary-approach-versus-posterior-extensive-circumferential-decompression-in-the-treatment-of-complicated-thoracic-and-lumbar-tuberculous-spondylitis
#19
Khaled Omran, Ahmed S Abdel-Fattah, Ahmed M A Othman, Ahmed O Youssef, Amr Solimen, Mohamed A ElRefai, Ahmed N Saleh, Mohammed Ali
OBJECTIVES AND STUDY DESIGN: The aim of this study was to retrospectively evaluate 45 patients operated upon either by posterior extensive circumferential decompression (PECD) or by the lateral extracavitary (LEC) technique and compare the clinical, radiologic, laboratory, and functional outcomes. SUMMARY OF BACKGROUND: The debate continues on the best decompression-fusion technique for treating complicated spinal tuberculosis. In recent times, the advantages of combined surgery have been successfully achieved using the 1-stage salvage technique, with enough accessibility to all 3 spinal columns...
December 21, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27995452/an-optimal-approach-for-laparoscopic-d3-lymphadenectomy-plus-complete-mesocolic-excision-d3-cme-for-right-sided-colon-cancer
#20
Daxing Xie, Chaoran Yu, Chun Gao, Hasan Osaiweran, Junbo Hu, Jianping Gong
BACKGROUND: It is common knowledge that high ligation of blood vessels at the D3 level and complete mesocolic excision (CME) are two critical points of right hemicolectomy for right colon cancer (RCC). (1-5) To date, a safe strategy for completing these two procedures under laparoscopic surgery has not been extensively described. The authors provide a video to demonstrate laparoscopic right hemicolectomy (D3 + CME) with an optimal mesentery-defined approach. By identifying three "tri-junctions," this approach facilitates dissection of the entire mesocolon along the embryologic planes as far centrally as possible and enables the high tie of feeding vessels at bifurcation...
December 19, 2016: Annals of Surgical Oncology
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