medical tips

BACKGROUND: We aimed to study the impact of operative time on textbook outcome (TO), especially postoperative complications and length of postoperative stay in minimally invasive esophagectomy. METHODS: Patients undergoing esophagectomy for curative intent within a prospectively maintained database from 2016 to 2022 were retrieved. Relationships between operative time and outcomes were quantified using multivariable mixed-effects models with medical teams random effects...

BACKGROUND: Liquid rhinoplasty, a non-surgical procedure using hyaluronic acid (HA) to reshape and refine the nose, has gained in popularity as an alternative to traditional surgical rhinoplasty although its results are not definitive. However, the lack of standardized injection protocols has raised concerns about treatment consistency and patient safety. OBJECTIVES: In this article, the authors propose a systematic protocol for the most common indications of liquid rhinoplasty...

Information may be required within a short time-frame for making decisions about programmes and interventions in health professions education. Rapid research methods have been increasingly used in healthcare, especially for qualitative research studies and literature reviews. An essential aspect of using rapid research methods is pragmatism, in which there is a balance between the constraints of the short time frame (typically less than 3 months), the available resources, and the rigour for an appropriate standard of quality...

Medical therapy of pericarditis should be targeted at its aetiology. Unfortunately, many cases of pericarditis remain idiopathic after a complete diagnostic workup. In such cases, empiric anti-inflammatory therapy for pericarditis is aimed at controlling symptoms and preventing recurrences. The aim of the present clinical review is to summarize published evidence, guidelines, and to provide tips and tricks for clinical management of acute and recurrent pericarditis.

When sea urchin puncture injuries occur during coastal recreation or work activities, they often affect extremities, such as hands and feet. There is a plethora of information on treatments for these puncture injuries, with the most common among medical professionals being the removal of all partially embedded spines and the removal of as many fully embedded spines as possible. When the spines are deeply embedded and/or fragmented, they might not be removed, especially when they are not located in critical areas such as tendons or joints...

Percutaneous insertion is one of the most common minimally invasive procedures. Compared with traditional straight rigid needles, bevel-tipped flexible needle can generate curved trajectories to avoid obstacles and sensitive organs. However, the nonlinear large deflection problem challenges the bending prediction of the needle, which dramatically influences the surgical success rate. This paper analyzed the mechanism of needle-tissue interaction, and established a mechanics-based model of the needle bending during an insertion...

PURPOSE: To investigate and characterize the performance of a novel orthogonal dual-layer alpha multileaf collimator (αMLC) mounted on the LinaTech VenusX linac. METHODS: We evaluated leaf positioning accuracy and reproducibility using an electronic portal imaging device through the picket fence test. The average, interleaf, intraleaf, and leaf tip transmissions of the single and dual layers were measured using an ionization chamber. Square and rhombus fields were used to evaluate the leaf penumbra of αMLC...

Transdermal delivery of peptide drugs is almost impossible with conventional penetration enhancers because of epidermal barrier function. Microneedle (MN) patches can bypass the epidermal barrier and have been developed for trans- and intradermal delivery of peptide drugs and vaccines. However, dissolving MN patches are limited by low drug loading capacities due to their small size and admixture of drug and water-soluble excipients. Furthermore, few in vivo pharmacokinetic studies, especially in large animals such as pigs, have been performed to assess post-application systemic drug exposure...

Learners across the medical education continuum will encounter numerous high-stakes exams and assessments. Effectively preparing for and performing well on these types of assessments can be challenging for learners for a wide variety of reasons. It is imperative that medical educators provide appropriate support for learners who experience challenges with high-stakes exams, particularly given the complexity of factors like life circumstances of individual learners and the significance of these assessments for career advancement/progression...

Here, we report on the process of a highly impactful and successful creative, collaborative, and multi-partner public engagement project, Radiation Reveal. It brought together ten young adults aged 17-25-year-olds with experience of radiotherapy with researchers at Cancer Research UK RadNet City of London across three 2-hour online workshops. Our aims were to 1) initiate discussions between young adults and radiation researchers, and 2) identify what people wish they had known about radiotherapy before or during treatment...

Bedside teaching is a key component of education at medical school, particularly in the clinical years. It provides an invaluable opportunity for students to practise examining patients, and further develops their communication and professional skills. Doctors who have newly graduated from medical school are often expected to provide such teaching to medical students placed on their wards. However, foundation doctors often receive little to no training for bedside teaching and there is limited literature on practical tips on how to enhance bedside teaching...

BACKGROUND: Chronic total occlusions with ambiguous proximal caps pose a challenging problem in below-the-knee artery endovascular interventions. CASE REPORT: We defined a new technique for antegrade puncture and penetration of an ambiguous proximal cap in a 52-year old male patient with a non-healing wound on his right forefoot. Anterior tibial artery (ATA) was determined as the target vessel; however, its origin and course could not be determined. A retrograde guidewire (Asahi Gladius 0...

Celsus gave an adequate description of the bones and sutures of the calvarium. His classification of injuries was simple including fissures and depressions. He is the first to relate specific symptoms to specific tissue injury. In addition, he was aware that fractures could be present in the absence of typical findings. He was also the first to note the meningeal vessels could rupture producing severe localized pain. His treatment was more conservative than that of Hippocrates. Plasters were to be used and if there was no deterioration trepanation was avoided...

BACKGROUND: A non-tunneled dialysis catheter (nTDC) is often the vascular access of choice to initiate dialysis in an intensive care unit (ICU). In the absence of contraindications, if a patient remains dialysis dependent beyond 2-weeks, the options are either to replace the nTDC with another nTDC or convert to a tunneled dialysis catheter (TDC). As a standard of care, TDCs are placed under fluoroscopic guidance. OBJECTIVES: To determine if TDCs and other tunneled central venous catheters (tCVC) can be placed safely using anatomical landmark techniques without the use of fluoroscopy...

BACKGROUND AND OBJECTIVE: Prostate cancer (PCa) is the second most common male cancer in the United States. Although new drugs have recently been approved, clinical challenges remain, notably the precise detection and prognostic implications of drug-resistant PCa. Extracellular vesicles (EVs), nanoscale lipid membrane vesicles, are actively secreted into the extracellular milieu by a variety of cell types. Over the past decade, interest in EVs has grown, and emerging evidence suggests that EVs play pivotal roles in cancer biology...

Simulation training in healthcare settings has become a valuable training tool. It provides an ideal formative assessment for interdisciplinary teaching. It provides a high fidelity and highly immersive environment where healthcare staff and students can practice developing their skills in a safe and controlled manner. Simulation training allows staff to practice skills that better prepare them for clinical emergencies, therefore possibly optimising clinical care. While the benefits of simulation education are well understood, establishing a programme for use by critical care staff is complex...

AIM: The aim of the present study was to evaluate the efficacy of 30° -angled Er:YAG laser tip and different periodontal instruments on root surface roughness and morphology in vitro. METHODS: Eighteen bovine teeth root without carious lesion were decoronated from the cementoenamel junction and seperated longitidunally. A total of 36 obtained blocks were mounted in resin blocks and polished with silicon carbide papers under water irrigation. These blocks were randomly assigned into 3 treatment groups...

The clinical data of 23 patients undergoing real-time echocardiography-guided infusion port implantation in the Breast Center of Tsinghua Changgung Hospital in Beijing from January to July 2021 were analyzed. The length of catheter insertion L1 was initially estimated using surface measurement method in all patients. Intraoperatively, transthoracic echocardiography was applied using the parasternal four-chamber view to visualize the catheter image within the right atrium, and the length of catheter insertion L2 was recorded under the guidance of echocardiography...

PURPOSE: The XXX Annual Scientific Meeting Medical Student Research and Mentorship Award (XXX ASM MSRMA) was established in 2020 to support medical students pursuing radiation oncology (RO) research and RO as a career. This study is an evaluation of the impact of this national research and mentorship award on medical students, resident mentors, and research supervisors over three iterations. METHODS: Three separate surveys were created for: medical student mentees, RO resident mentors, and attending research supervisors...

Deep endometriosis (DE) can be localized in the parametrium, a complex bilateral anatomical structure, sometimes necessitating intricate surgical intervention due to the potential involvement of autonomic nerves, uterine artery, and ureter. If endometriotic ovarian cysts have been considered metaphorically representative of "the tip of the iceberg" concerning concealed DE lesions, it is reasonable to assert that parametrial lesions should be construed as the most profound region of this iceberg. Also, based on a subdual clinical presentation, a comprehensive diagnostic parametrial evaluation becomes imperative to strategize optimal management for patients with suspected DE...