June 12th, 2011 by Bongi in True Stories
No Comments »
Sometimes different people see the same thing from a slightly different angle, giving a completely different perspective. In my line this can turn out to be quite macabre.
It was one of those cases. It was probably hopeless from the beginning, but he was young and we had to give it a go. As soon as the abdomen was opened everyone knew things were bad. There was blood everywhere. It took a while to even see the damage to the liver because I needed to get rid of the blood in the abdomen before I could see anything. However, once I saw the liver even I was shocked.
The liver was ripped apart with one laceration dropping down to where the IVC sat menacingly behind it. It seemed to spit and splutter at my efforts to bring the bleeding under control in defiance of me. But I did what I could as fast as I could. At times like this the unsung hero is the anesthetist. If he can’t get fluid and blood into the patient fast enough, no matter what the surgeon does, it will be in vain. That day the anesthetist was great. Somehow he kept some semblance of a blood pressure in the patient against overwhelming odds. Read more »
*This blog post was originally published at other things amanzi*
June 10th, 2011 by Peggy Polaneczky, M.D. in Health Tips
No Comments »
In a large multicenter study enrolling over 70,000 women, annual screening with transvaginal pelvic ultrasound and ca125 blood testing did not reduce deaths from ovarian cancer, and in fact led to an increase in complications due to screening.
Investigators in the NCI-sponsored Prostate, Lung and Ovarian Cancer (PLCO) Screening trial randomly assigned over 78,000 women age 55-64 years of age to either annual screening with transvaginal pelvic sonograms for 4 years plus CA125 testing for 6 years or usual care at 10 study sites across the US., and followed the groups for up to 13 years. Over that time period, ovarian cancer rates in the screened group were 5.7 per 10,000 person-years vs 4.7 per 10,000 persons-years in the usual care group, with 3.1 deaths vs 2.6 deaths per 10,000 person years, respectively. Over 3000 women had false positive screening results, a third of whom had surgery and 15% of those operated on had a complications from their surgery. Deaths from other causes did not differ between the groups.
The investigators concluded that annual screening for ovarian cancer does not reduce mortality, and in fact caused harms among women with fals positive abnormal results.
This is not the first study that failed to find efficacy for ultrasound and ca125 in reducing mortality from ovarian cancer, but Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
June 9th, 2011 by RamonaBatesMD in Health Tips
1 Comment »
Earlier this week this tweet from @prsjournal caught my eye
Most Popular: Management of Horse and Donkey Bite Wounds: A Series of 24 Cases: No abstract available http://bit.ly/lgNkCS
I missed this article when it came out in the June 2010 issue of the Plastic and Reconstructive Surgery Journal. As I have covered fire ant bites, cat bites, and snake bites. Fellow blogger Bongi has written about hippo bites. It’s time to cover horse and donkey bites.
Dr. Köse, Department of Plastic and Reconstructive Surgery, Harran University Hospital, Turkey and colleagues presented a retrospective evaluation of 24 patients treated for animal bites (19 horse and five donkey bites) from 2003 to 2009. The head and neck were the most frequent bite sites (14 cases), followed by the extremities (8 cases) and the trunk (2 cases).
The article is very short, representing their personal viewpoint and experience. Read more »
*This blog post was originally published at Suture for a Living*
June 4th, 2011 by DeborahSchwarzRPA in News
No Comments »
New York Times article highlights transplant donor and recipients at New York-Presbyterian Hospital
UK NHS Organ Donation Checkbox
As organ transplantation has advanced and improved in recent decades, more and more patients’ lives are saved every year. But the most pressing problem in organ transplantation has yet to be solved: the shortage of donor organs available to the thousands of people waiting on lists for a new kidney, liver, lung, heart, or other organ. People who intend to donate may not indicate their wishes to family members before their death, or families are reluctant to make that decision in the midst of profound grief and loss. For others, donating an organ was just never something they knew much about or even considered.
When they do choose to donate a loved one’s organs, families usually remain anonymous, as do those whose lives they save. Perhaps that is why articles like the one in the New York Times on May 16, 2011, touch and inspire readers so deeply. This version of an increasingly common story captures the essential soul-searching, as well as the profound gratitude, hope, and solace, that marked the meeting of Mirtala Garcia and the people who received her husband’s organs. Read more »
*This blog post was originally published at Columbia University Department of Surgery Blog*
June 3rd, 2011 by John Di Saia, M.D. in Health Tips
No Comments »
I have had a capsulectomy due to capsular contraction, but now it has returned. I want an explant because they are uncomfortable and look unnatural. My doctor said that since the capsulectomy did not resolve the issue, he recommends having an explant and waiting about 6 months to a year. After my body has healed properly, he said that I can get implants again and will not get capsular contraction again. Is this accurate? Am I less likely to get capsular contraction or will I be free of capsular contraction? I’m also looking for a doctor experienced in explants.
The subject of hardened breast implants (Capsular Contracture) comes up frequently as it is the leading cause of long term dissatisfaction with breast implants. If your breasts tend to hurt or look unnatural, you likely have severe encapsulation (Baker Grade III or IV.) When contracture redevelops quickly after capsulectomy (assuming the operation was thorough,) this is worrisome as it may indicate a high tendency for recurrence. The main question when severe contracture is present is whether or not a cause can be identified. Bothersome contracture doesn’t happen to all patients. This kind of reaction is associated with cigarette smoking, bleeding, infection, silicone gel implants, poor soft tissue coverage and radiation exposure as well as a previous history of contracture. Some of these issues can be minimized in an attempt to reduce the tendency for encapsulation. Preventing the problem is the best solution. Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
Sometimes different people see the same thing from a slightly different angle, giving a completely different perspective. In my line this can turn out to be quite macabre.
