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Surgical ethics

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https://www.readbyqxmd.com/read/28928775/assessment-of-safety-and-functional-efficacy-of-stem-cell-based-therapeutic-approaches-using-retinal-degenerative-animal-models
#1
REVIEW
Tai-Chi Lin, Magdalene J Seiler, Danhong Zhu, Paulo Falabella, David R Hinton, Dennis O Clegg, Mark S Humayun, Biju B Thomas
Dysfunction and death of retinal pigment epithelium (RPE) and or photoreceptors can lead to irreversible vision loss. The eye represents an ideal microenvironment for stem cell-based therapy. It is considered an "immune privileged" site, and the number of cells needed for therapy is relatively low for the area of focused vision (macula). Further, surgical placement of stem cell-derived grafts (RPE, retinal progenitors, and photoreceptor precursors) into the vitreous cavity or subretinal space has been well established...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28928556/a-study-to-compare-the-quality-of-surgical-field-using-total-intravenous-anesthesia-with-propofol-versus-inhalational-anesthesia-with-isoflurane-for-functional-endoscopic-sinus-surgeries
#2
K S Aujla, Manbir Kaur, Ruchi Gupta, Sukhjinder Singh, Bhanupreet, Tavleen
BACKGROUND AND OBJECTIVES: Functional endoscopic sinus surgery (FESS) being a delicate technique, intraoperative bleeding is one of the major challenges. Even a little bleeding can adversely affect the surgeon's ability to visualize the region to be operated. General anesthesia is preferred over topical anesthesia in FESS. This study was conducted to compare the surgical field using total intravenous anesthesia (TIVA) with propofol and inhalational anesthesia with isoflurane for FESS...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927771/-impact-of-a-written-document-for-preoperative-information-on-the-use-of-internet-by-parents
#3
M Landier, T Villemagne, A Le Touze, K Braïk, P Meignan, A R Cook, B Morel, H Lardy, A Binet
INTRODUCTION: Preoperative information is a legal and ethical obligation. Very few studies have evaluated the preoperative information method in pediatrics. Having a child operated on is stressful for parents. The use of Internet to look for data on the pathology and its treatment is frequent, but often unprofitable and sometimes even harmful. This study aimed to measure the impact of a leaflet, which supports spoken information in preoperative consultation, on parents' use of the Internet before surgery...
September 15, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28922278/defining-the-critical-elements-for-the-most-common-procedures-in-spine-surgery-a-consensus-of-orthopaedic-and-neurosurgical-surgeons
#4
Joseph L Laratta, Samuel Cohen-Tanugi, Jamal N Shillingford, Joseph M Lombardi, Lawrence G Lenke, K Daniel Riew, Ronald A Lehman, Steven C Ludwig
STUDY DESIGN: Survey. OBJECTIVE: To define the critical elements of common spine surgeries. SUMMARY OF BACKGROUND DATA: Despite significant relevance to the field of spine surgery, the term "critical element" of surgery has not been clearly defined. Every surgical procedure involves numerous steps, each with its own potential for complications and harm to the patient. Despite its crucial role in surgical training, billing, and the ethicality of concurrent surgery, the term "critical element" of surgery has not been defined...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28901600/ethical-issues-raised-by-thyroid-cancer-overdiagnosis-a-matter-for-public-health
#5
Wendy A Rogers, Wendy L Craig, Vikki A Entwistle
Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelong thyroid replacement hormone, monitoring, surgical complications and other side effects...
October 2017: Bioethics
https://www.readbyqxmd.com/read/28889480/why-do-surgeons-receive-more-complaints-than-their-physician-peers
#6
Holly M Tibble, Nigel S Broughton, David M Studdert, Matthew J Spittal, Nicola Hill, Jennifer M Morris, Marie M Bismark
BACKGROUND: Compared with other doctors, surgeons are at an increased risk of medicolegal events, including patient complaints and negligence claims. This retrospective study aimed to describe the frequency and nature of complaints involving surgeons compared with physicians. METHODS: We assembled a national data set of complaints about surgeons and physicians lodged with medical regulators in Australia from 2011 to 2016. We classified the complaints into 19 issues across four domains: treatment and procedures, other performance, professional conduct and health...
September 9, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#7
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28887861/ultrasound-guided-intratumoral-radiofrequency-ablation-coagulation-to-facilitate-meningioma-resection-preliminary-experience
#8
Li Yan, Junle Yang, Xiaodong Zhou, Guangbin He, Yu Zheng, Yali Zhu, Weiping Liu, Wen Luo, Haiying Qin, Haijing Liu, Xicai Yi, Yin Zhou
OBJECTIVES: This study aimed to explore the feasibility and safety of intratumoral radiofrequency ablation (RFA) in meningioma resection. METHODS: This study was approved by the Xijing Ethics Committee, and informed consent was obtained from all of the patients. Thirteen patients with meningiomas were recruited in the Neurosurgery Department of Xijing Hospital. These patients were treated with intratumoral RFA and surgery. We also chose 13 patients with meningiomas treated with traditional surgery as the control group...
September 9, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28882925/snap-2-epiccs-the-second-sprint-national-anaesthesia-project-epidemiology-of-critical-care-after-surgery-protocol-for-an-international-observational-cohort-study
#9
S Ramani Moonesinghe, Danny J N Wong, Laura Farmer, Richard Shawyer, Paul S Myles, Steve K Harris
INTRODUCTION: The admission of high-risk patients to critical care after surgery is a recommended standard of care. Nevertheless, poor compliance against this recommendation has been repeatedly demonstrated in large epidemiological studies. It is unclear whether this is due to reasons of capacity, equipoise, poor quality clinical care or because hospitals are working creatively to create capacity for augmented care on normal surgical wards. The EPIdemiology of Critical Care after Surgery study aims to address these uncertainties...
September 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28882141/3-dimensional-versus-conventional-laparoscopy-for-benign-hysterectomy-protocol-for-a-randomized-clinical-trial
#10
Elise Hoffmann, Gitte Bennich, Christian Rifbjerg Larsen, Jannie Lindschou, Janus Christian Jakobsen, Pernille Danneskiold Lassen
BACKGROUND: Hysterectomy is one of the most common surgical procedures for women of reproductive age. Laparoscopy was introduced in the 1990es and is today one of the recommended routes of surgery. A recent observational study showed that operative time for hysterectomy was significantly lower for 3-dimensional compared to conventional laparoscopy. Complication rates were similar for the two groups. No other observational studies or randomized clinical trials have compared 3-dimensional to conventional laparoscopy in patients undergoing total hysterectomy for benign disease...
September 7, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28881890/active-surveillance-in-clinically-complete-responders-after-neoadjuvant-chemoradiotherapy-for-esophageal-or-junctional-cancer
#11
B J Noordman, B P L Wijnhoven, S M Lagarde, K Biermann, A van der Gaast, M C W Spaander, R Valkema, J J B van Lanschot
Neoadjuvant chemoradiotherapy (nCRT) followed by surgery is standard of care for locally advanced esophageal cancer in many countries. After nCRT up to one third of all patients have a pathologically complete response in the resection specimen, posing an ethical imperative to reconsider the necessity of standard surgery in all operable patients after nCRT. An active surveillance strategy following nCRT, in which patients are subjected to frequent clinical investigations after the completion of neoadjuvant therapy, has been evaluated in other types of cancer with promising results...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28877863/the-paget-trial-a-multicenter-observational-cohort-intervention-study-for-the-clinical-efficacy-safety-and-immunological-response-of-topical-5-imiquimod-cream-for-vulvar-paget-disease
#12
Michelle van der Linden, Kim Meeuwis, Colette van Hees, Eleonora van Dorst, Johan Bulten, Tjalling Bosse, Joanna IntHout, Dorry Boll, Brigitte Slangen, Manon van Seters, Marc van Beurden, Mariëtte van Poelgeest, Joanne de Hullu
BACKGROUND: Vulvar Paget disease is a rare skin disorder, which is most common in postmenopausal Caucasian women. They usually present with an erythematous plaque that may show fine or typical "cake icing" scaling or ulceration that may cause itching, pain, irritation, or a burning sensation. Although most cases are noninvasive, vulvar Paget disease may be invasive or associated with an underlying vulvar or distant adenocarcinoma. The histological evidence of so-called "Paget cells" with abundant pale cytoplasm in the epithelium confirms the diagnosis...
September 6, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28876681/south-african-surgical-registrar-perceptions-of-the-research-project-component-of-training-hope-for-the-future
#13
N Patel, P Naidoo, T Govender, J Klopper, M D Smith, J Loveland
BACKGROUND: The Health Professions Council of South Africa requires that a research project be submitted and passed before registration as a specialist. METHOD: Ethics clearance was received before commencing the study. A questionnaire was developed to collect feedback from surgical registrars throughout South Africa (SA). Completed questionnaires underwent descriptive analysis using MS Excel. Fisher's exact test and the χ2 test were used to compare perceptions of the research-experienced and research-naive groups...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876680/registrar-perceptions-on-general-surgical-training-in-south-africa-a-report-by-the-south-african-society-of-surgeons-in-training-sassit
#14
N Patel, A Leusink, N Singh, M Z Koto, T Luvhengo
BACKGROUND: Surgical training varies significantly even amongst universities within the same country. This trend is reflected in South Africa and provides an opportunity for innovation to improve the quality of general surgical training. METHOD: A prospective descriptive study was performed by means of a confidential questionnaire distributed to general surgical registrars at all 8 training centres in South Africa. Participants were asked to give comments regarding adequacy of formal academic teaching, level of supervision during surgical procedures, exposure to and training in minimally invasive surgery (MIS), and preparation for examinations...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876621/the-absolute-number-of-repeat-operations-for-complex-intra-abdominal-sepsis-is-not-a-useful-predictor-of-non-survival
#15
M F Scriba, G L Laing, J L Bruce, D L Clarke
BACKGROUND: When multiple repeat laparotomies are required to manage intra-abdominal sepsis, questions about futility of treatment frequently arise. This study focuses specifically on patients who required two or more repeat laparotomies and describes the spectrum of disease necessitating multiple repeat laparotomies and the associated outcomes in the hope of clarifying the issue. METHOD: This study was conducted over a 20-month period (December 2012 - July 2014) at Greys Hospital in Pietermaritzburg, South Africa...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876566/a-survey-of-selected-key-areas-of-management-of-south-african-neurosurgical-patients
#16
C H Daniel, M D du Trevou
BACKGROUND: Previous surveys of neurosurgical patient management, including a South African (SA) survey conducted in 2001, confirmed the existence of significant dissimilarities in management on national and international levels. This survey aimed to determine current SA neurosurgical patient management and to compare this with international trends. METHOD: Questionnaires in multiple choice question (MCQ) and free text entry format covering key areas of neurosurgical practice were emailed to SA neurosurgeons following ethics approval...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28872767/one-hundred-twenty-five-fat-myringoplasties-does-marginal-perforation-matter
#17
Giuseppe Malafronte, Barbara Filosa
OBJECTIVE: to evaluate if calcified plaques adjacent to the perforation and marginal perforations are real contraindications to the fat graft myringoplasty. STUDY DESIGN: prospective study. METHODS: This study was conducted, from 1(st) January 2008 to 31 December 2015 at our Otolaryngology Department of S.G. Moscati Hospital. The investigation included 125 patients, 60 males and 65 females, affected by COM who have undergone fat graft myringoplasty between 01/01/2008 to 31/12/2011...
September 5, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28870724/tubal-sterilization-in-women-under-30-case-series-and-ethical-implications
#18
Dylan Ehman, Dustin Costescu
OBJECTIVE: According to the SOGC Contraception Consensus, it is recommended that permanent contraception be offered to women regardless of age or parity. Many women who desire sterilization at a young age experience barriers from physicians who decline to facilitate the request. METHODS: As part of a quality assurance project, we performed a review of cases where tubal sterilization was performed in women under 30 over a 42-month period (September 2013-March 2017)...
September 1, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28867778/nurse-perceptions-of-artists-as-collaborators-in-interprofessional-care-teams
#19
Jill Sonke, Virginia Pesata, Jenny Baxley Lee, John Graham-Pole
Increased attention is being given to interprofessional collaboration in healthcare, which has been shown to improve patient satisfaction, patient safety, healthcare processes, and health outcomes. As the arts and artists are being more widely incorporated into healthcare settings throughout the world, professional artists are contributing to interprofessional care teams. A secondary directed content analysis of interviews with 31 nurses on a medical-surgical care unit investigated the roles and impacts of professional artists on the interprofessional care team...
August 30, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28867584/coalition-for-global-clinical-surgical-education-the-alliance-for-global-clinical-training
#20
Jahanara Graf, Mackenzie Cook, Samuel Schecter, Karen Deveney, Paul Hofmann, Douglas Grey, Larry Akoko, Ali Mwanga, Kitembo Salum, William Schecter
OBJECTIVE: Assessment of the effect of the collaborative relationship between the high-income country (HIC) surgical educators of the Alliance for Global Clinical Training (Alliance) and the low-income country surgical educators at the Muhimbili University of Health and Allied Sciences/Muhimbili National Hospital (MUHAS/MNH), Dar Es Salaam, Tanzania, on the clinical global surgery training of the HIC surgical residents participating in the program. DESIGN: A retrospective qualitative analysis of Alliance volunteer HIC faculty and residents' reports, volunteer case lists and the reports of Alliance academic contributions to MUHAS/MNH from 2012 to 2017...
August 31, 2017: Journal of Surgical Education
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