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Essential Surgical Knowledge

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2343 papers 1000+ followers Papers from the recent literature which are of interest to residents and practicing surgeons
Huseyin Naci, Courtney Davis, Jelena Savović, Julian P T Higgins, Jonathan A C Sterne, Bishal Gyawali, Xochitl Romo-Sandoval, Nicola Handley, Christopher M Booth
OBJECTIVE: To examine the design characteristics, risk of bias, and reporting adequacy of pivotal randomised controlled trials of cancer drugs approved by the European Medicines Agency (EMA). DESIGN: Cross sectional analysis. SETTING: European regulatory documents, clinical trial registry records, protocols, journal publications, and supplementary appendices. ELIGIBILITY CRITERIA: Pivotal randomised controlled trials of new cancer drugs approved by the EMA between 2014 and 2016...
September 18, 2019: BMJ: British Medical Journal
Ryan S D'Souza, Rebecca L Johnson, Layne Bettini, Phillip J Schulte, Christopher Burkle
OBJECTIVE: To compare recall of complications and surgical details discussed during informed consent and perception of the consent process in patients undergoing emergent vs elective surgery. METHODS: Studies were identified from PubMed, Cochrane, Web of Science, and Scopus from January 1, 1966, through April 18, 2018. Included studies compared patient recall and perception regarding informed consent in those undergoing emergent vs elective surgery. Pooled odds ratios (ORs) were calculated for recall of complications and surgical details, patient satisfaction, perception of sufficient information being delivered on surgical risks, report of having read written consent, and factors that interfered with consent...
September 2019: Mayo Clinic Proceedings
Christopher Yheulon, S Scott Davis
No abstract text is available yet for this article.
September 4, 2019: JAMA Surgery
Douglas B Evans, Mandana Kamgar, Susan Tsai
No abstract text is available yet for this article.
September 6, 2019: Annals of Surgical Oncology
Nichola Cooper, Waleed Ghanima
New England Journal of Medicine, Volume 381, Issue 10, Page 945-955, September 2019.
September 5, 2019: New England Journal of Medicine
R Louise Rushworth, David J Torpy, Henrik Falhammar
New England Journal of Medicine, Volume 381, Issue 9, Page 852-861, August 2019.
August 29, 2019: New England Journal of Medicine
Todd H Baron, Christopher J DiMaio, Andrew Y Wang, Katherine A Morgan
DESCRIPTION: The purpose of this AGA Institute Clinical Practice Update is to review the available evidence and expert recommendations regarding the clinical care of patients with pancreatic necrosis and to offer concise best practice advice for the optimal management of patients with this highly morbid condition. METHODS: This expert review was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology...
August 31, 2019: Gastroenterology
Sharon R Lewis, Oliver J Schofield-Robinson, Sarah Rhodes, Andrew F Smith
BACKGROUND: Hospital-acquired infection is a frequent adverse event in patient care; it can lead to longer stays in the intensive care unit (ICU), additional medical complications, permanent disability or death. Whilst all hospital-based patients are susceptible to infections, prevalence is particularly high in the ICU, where people who are critically ill have suppressed immunity and are subject to increased invasive monitoring. People who are mechanically-ventilated are at infection risk due to tracheostomy and reintubation and use of multiple central venous catheters, where lines and tubes may act as vectors for the transmission of bacteria and may increase bloodstream infections and ventilator-associated pneumonia (VAP)...
August 30, 2019: Cochrane Database of Systematic Reviews
Derek J Roberts, David A Zygun, Chad G Ball, Andrew W Kirkpatrick, Peter D Faris, Matthew T James, Kelly J Mrklas, Brenda D Hemmelgarn, Braden Manns, Henry T Stelfox
BACKGROUND: As it may be argued that many surgical interventions provide obvious patient benefits, formal, staged assessment of the efficacy and safety of surgical procedures has historically been and remains uncommon. The majority of innovative surgical procedures have therefore often been developed based on anatomical and pathophysiological principles in an attempt to better manage clinical problems. MAIN BODY: In this manuscript, we sought to review and contrast the models for pharmaceutical and surgical innovation in North America, including their stages of development and methods of evaluation, monitoring, and regulation...
August 27, 2019: BMC Surgery
Pringl Miller
No abstract text is available yet for this article.
October 2019: Surgical Clinics of North America
Seth Felder, Morten Schnack Rasmussen, Ray King, Bradford Sklow, Mary Kwaan, Robert Madoff, Christine Jensen
BACKGROUND: This an update of the review first published in 2009.Major abdominal and pelvic surgery carries a high risk of venous thromboembolism (VTE). The efficacy of thromboprophylaxis with low molecular weight heparin (LMWH) administered during the in-hospital period is well-documented, but the optimal duration of prophylaxis after surgery remains controversial. Some studies suggest that patients undergoing major abdominopelvic surgery benefit from prolongation of the prophylaxis up to 28 days after surgery...
August 26, 2019: Cochrane Database of Systematic Reviews
Helmi Khadra, Hillary Johnson, Jason Crowther, Patrick McClaren, Michael Darden, Geoffrey Parker, Joseph F Buell
BACKGROUND: Bile duct injury during laparoscopic cholecystectomy persists as a significant problem in general surgery, resulting in complex injuries, arterial damage, and post repair strictures. METHODS: We performed a retrospective analysis between 2 eras of bile duct injury repairs: 1987 to 2001 (n = 58) and 2002 to 2016 (n = 52) using logistic regression analyses to assess presentation, repair complexity, and outcomes. RESULTS: No differences in demographics, incidence of cholecystitis, conversion, time to presentation, level of injury, or arterial injury were identified...
August 19, 2019: Surgery
Benoit Guery, Tatiana Galperine, Frédéric Barbut
Clostridioides difficile (formerly Clostridium ) is a major cause of healthcare associated diarrhea, and is increasingly present in the community. Historically, C difficile infection was considered easy to diagnose and treat. Over the past two decades, however, diagnostic techniques have changed in line with a greater understanding of the physiopathology of C difficile infection and the use of new therapeutic molecules. The evolution of diagnosis showed there was an important under- and misdiagnosis of C difficile infection, emphasizing the importance of algorithms recommended by European and North American infectious diseases societies to obtain a reliable diagnosis...
August 20, 2019: BMJ: British Medical Journal
Boris Jung, Mikaël Martinez, Yann-Erick Claessens, Michaël Darmon, Kada Klouche, Alexandre Lautrette, Jacques Levraut, Eric Maury, Mathieu Oberlin, Nicolas Terzi, Damien Viglino, Youri Yordanov, Pierre-Géraud Claret, Naïke Bigé
Metabolic acidosis is a disorder frequently encountered in emergency medicine and intensive care medicine. As literature has been enriched with new data concerning the management of metabolic acidosis, the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the French Emergency Medicine Society (Société Française de Médecine d'Urgence [SFMU]) have developed formalized recommendations from experts using the GRADE methodology. The fields of diagnostic strategy, patient assessment, and referral and therapeutic management were addressed and 29 recommendations were made: 4 recommendations were strong (Grade 1), 10 were weak (Grade 2), and 15 were experts' opinions...
August 15, 2019: Annals of Intensive Care
Kevin Davidson, Samira Shojaee
Massive hemoptysis is a medical emergency with high mortality presenting several difficult diagnostic and therapeutic challenges. The origin of bleeding and underlying etiology often is not immediately apparent and techniques for management of this dangerous condition necessitate an expedient response. Unlike hemorrhage in other circumstances, a small amount of blood can rapidly flood the airways thereby impairing oxygenation and ventilation leading to asphyxia and consequent cardiovascular collapse. Of paramount importance is early control of the patient's airway and immediate isolation of hemorrhage in an attempt to localize and control bleeding...
July 30, 2019: Chest
Stephanie Clare Roth
Genomic medicine is rapidly changing the future of medicine. Medical librarians need to understand this field of research and keep current with its latest advancements. Even if they are not directly involved in genomic medicine, librarians can play an integral role by helping health care consumers and practitioners who may also need to expand their knowledge in this area. This article provides a basic introduction to genomic medicine, gives a brief overview of its recent advancements, and briefly describes some of the ethical, legal, and social implications of this emerging area of research and practice...
July 2019: Journal of the Medical Library Association: JMLA
S J Chapman, M Aldaffaa, C L Downey, D G Jayne
BACKGROUND: Research waste is a major challenge for evidence-based medicine. It implicates misused resources and increased risks for research participants. The aim of this study was to quantify constituent components of waste in surgical RCTs and explore targets for improvement. METHODS: was searched for RCTs registered between January 2011 and December 2012 using the keyword 'surgery'. The primary outcome was research waste, defined as non-publication, inadequate reporting or presence of an avoidable design limitation...
August 8, 2019: British Journal of Surgery
Yosef Y Nasseri, Ruoyan Zhu, Christine Sutanto, Christina Wai, Jason S Cohen, Joshua Ellenhorn, Avo Artinyan
BACKGROUND: There is little consensus with regards to the most appropriate surgical management for low-grade appendiceal mucinous adenocarcinomas (LAMA), though right hemicolectomy is usually recommended. METHODS: The SEER database was queried for all patients with non-metastatic LAMA. Disease specific and overall survival was compared by surgery type: 1) appendectomy, 2) formal right hemicolectomy 3) non-formal colectomy (including ileocecectomy). RESULTS: A total of 579 patients with non-metastatic LAMA were identified...
July 25, 2019: American Journal of Surgery
Nigel S Key, Alok A Khorana, Nicole M Kuderer, Kari Bohlke, Agnes Y Y Lee, Juan I Arcelus, Sandra L Wong, Edward P Balaban, Christopher R Flowers, Charles W Francis, Leigh E Gates, Ajay K Kakkar, Mark N Levine, Howard A Liebman, Margaret A Tempero, Gary H Lyman, Anna Falanga
PURPOSE: To provide updated recommendations about prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer. METHODS: PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs published from August 1, 2014, through December 4, 2018. ASCO convened an Expert Panel to review the evidence and revise previous recommendations as needed. RESULTS: The systematic review included 35 publications on VTE prophylaxis and treatment and 18 publications on VTE risk assessment...
August 5, 2019: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
David R Urbach, Justin B Dimick, Alex B Haynes, Atul A Gawande
No abstract text is available yet for this article.
August 5, 2019: BMJ: British Medical Journal
2019-08-08 15:02:23
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