PubSurg

Evaluation and stages of surgical innovations : The Lancet

Fri, 25 Sep 2009 12:23:36 -0400

Evaluation and stages of surgical innovations : The Lancet:

This themed issue of LANCET is featuring Surgery. A long way from “comic opera”.

PLoS ONE: Early In-Hospital Mortality following Trainee Doctors' First Day at Work

Fri, 25 Sep 2009 09:38:26 -0400

PLoS ONE: Early In-Hospital Mortality following Trainee Doctors' First Day at Work:

No difference in surgery.

Current Management of Colorectal Hepatic Metastasis

Wed, 23 Sep 2009 16:26:49 -0400

Current Management of Colorectal Hepatic Metastasis:

A nice review.

NEJM -- The Writing on the Wall

Thu, 10 Sep 2009 06:16:50 -0400

NEJM -- The Writing on the Wall:

No exactly surgery, but NEJM does it again. Medicine 2.0 at its best!

Morning colonoscopy may catch more polyps | Health | Reuters

Thu, 13 Aug 2009 12:56:13 -0400

Morning colonoscopy may catch more polyps | Health | Reuters:

Polyps were found in 29 percent of patients who had a colonoscopy in the morning, versus 25 percent of those who were screened in the afternoon. There was also evidence that detection rates dipped as the day wore on, according to findings published the American Journal of Gastroenterology.

JAMA -- Abstract: Aspirin Use and Survival After Diagnosis of Colorectal Cancer, August 12, 2009, Chan et al. 302 (6): 649

Wed, 12 Aug 2009 03:11:31 -0400

JAMA -- Abstract: Aspirin Use and Survival After Diagnosis of Colorectal Cancer, August 12, 2009, Chan et al. 302 (6): 649:

Conclusion Regular aspirin use after the diagnosis ofcolorectal cancer is associated with lower risk of colorectalcancer–specific and overall mortality, especially amongindividuals with tumors that overexpress COX-2.

Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery.

Wed, 12 Aug 2009 01:23:54 -0400

Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery.:

British Journal of Surgery

Lidocaine Reduces Pain and Anxiety From Peripheral IV Cannula Insertion

Tue, 11 Aug 2009 07:18:42 -0400

Lidocaine Reduces Pain and Anxiety From Peripheral IV Cannula Insertion:

Its cool, but…..WHO does that???

Chest radiography of life-supporting medical interventions

Sat, 08 Aug 2009 08:45:16 -0400

Chest radiography of life-supporting medical interventions

Journal of GI Surgery - Repair of Abdominal Wall Hernias with Restoration of Abdominal Wall Function

Fri, 07 Aug 2009 15:32:52 -0400

Journal of GI Surgery - Repair of Abdominal Wall Hernias with Restoration of Abdominal Wall Function:

Dr. Rosens amazing new method!

NEJM -- Apixaban or Enoxaparin for Thromboprophylaxis after Knee Replacement

Thu, 06 Aug 2009 13:43:26 -0400

NEJM -- Apixaban or Enoxaparin for Thromboprophylaxis after Knee Replacement:

Conclusions As compared with enoxaparin for efficacy of thromboprophylaxisafter knee replacement, apixaban did not meet the prespecifiedstatistical criteria for noninferiority, but its use was associatedwith lower rates of clinically relevant bleeding and it hada similar adverse-event profile.

I will restart the blog

Tue, 04 Aug 2009 15:20:56 -0400

Due to new interest in surgery 2.0 I will restart the postings.

JAMA: Diagnostic Accuracy of Computed Tomographic Colonography for the Detection of Advanced Neoplasia in Individuals at Increased Risk of Colorectal Cancer

Sat, 20 Jun 2009 07:43:00 -0400

Regge, D., Laudi, C., Galatola, G., Della Monica, P., Bonelli, L., Angelelli, G., Asnaghi, R., Barbaro, B., Bartolozzi, C., Bielen, D., Boni, L., Borghi, C., Bruzzi, P., Cassinis, M. C., Galia, M., Gallo, T. M., Grasso, A., Hassan, C., Laghi, A., Martina, M. C., Neri, E., Senore, C., Simonetti, G., Venturini, S., Gandini, G. on 6/16/09 Context Computed tomographic (CT) colonography has been recognized as an alternative for colorectal cancer (CRC) screening in average-risk individuals, but less information is available on its performance in individuals at increased risk of CRC. Objective To assess the accuracy of CT colonography in detecting advanced colorectal neoplasia in asymptomatic individuals at increased risk of CRC using unblinded colonoscopy as the reference standard. Design, Setting, and Participants This was a multicenter, cross-sectional study. Individuals at increased risk of CRC due to either family history of advanced neoplasia in first-degree relatives, personal history of colorectal adenomas, or positive results from fecal occult blood tests (FOBTs) were recruited in 11 Italian centers and 1 Belgian center between December 2004 and May 2007. Each participant underwent CT colonography followed by colonoscopy on the same day. Main Outcome Measures Sensitivity and specificity of CT colonography in detecting individuals with advanced neoplasia (ie, advanced adenoma or CRC) 6 mm or larger. Results Of 1103 participants, 937 were included in the final analysis: 373 cases in the family-history group, 343 in the group with personal history of adenomas, and 221 in the FOBT-positive group. Overall, CT colonography identified 151 of 177 participants with advanced neoplasia 6 mm or larger (sensitivity, 85.3%; 95% confidence interval [CI], 79.0%-90.0%) and correctly classified results as negative for 667 of 760 participants without such lesions (specificity, 87.8%; 95% CI, 85.2%-90.0%). The positive and negative predictive values were 61.9% (95% CI, 55.4%-68.0%) and 96.3% (95% CI, 94.6%-97.5%), respectively; after group stratification, a significantly lower negative predictive value was found for the FOBT-positive group (84.9%; 95% CI, 76.2%-91.3%; P < .001). Conclusions In a group of persons at increased risk for CRC, CT colonography compared with colonoscopy resulted in a negative predictive value of 96.3% overall. When limited to FOBT-positive persons, the negative predictive value was 84.9%. Things you can do from here: - Subscribe to JAMA current issue using Google Reader - Get started using Google Reader to easily keep up with all your favorite sites

Head and neck injury risks in heavy metal: head bangers stuck between rock and a hard bass

Tue, 23 Dec 2008 14:00:12 -0500

Head and neck injury risks in heavy metal: head bangers stuck between rock and a hard bass:

Due to having no Internet at home, this is my first post since couple of months.

But a good one, I think.

Clostridium difficile -- More Difficult Than Ever.

Fri, 31 Oct 2008 07:15:52 -0400

Clostridium difficile -- More Difficult Than Ever.

Poor Agreement Among Expert Witnesses in Bile Duct Injury Malpractice Litigation: An Expert Panel Survey.

Sat, 25 Oct 2008 02:56:46 -0400

Poor Agreement Among Expert Witnesses in Bile Duct Injury Malpractice Litigation: An Expert Panel Survey.:

Results: Thirteen independent experts reviewed 10 closed litigation cases. In 1 of the 10 cases, full agreement was observed. In 7 of the 10 cases, the highest percentage of agreeing experts was 53% or less. Chance-corrected levels of agreement were in the slight to fair range (Kendall W coefficient of concordance = 0.16-0.25). Disease-related mortality was associated with judgments on negligence (P = 0.02). Judgments on negligence of care were not associated with delay in diagnosis or the severity of injury. Experts with more years of clinical experience agreed more about negligence. Experts working in an academic setting agreed less than experts working in a teaching hospital. Finally, 8 of the 13 experts plead for the assignment of more than 1 expert witness to review and comment in a surgical litigation case.

[Ann Surg 2008]

Prognostic Factors for Gallbladder Cancer in Japan.

Sat, 25 Oct 2008 02:55:00 -0400

Prognostic Factors for Gallbladder Cancer in Japan.:

Results: Survival is related closely to the surgical stage. Five-year survival rates for stage I, II, III, IVA, and IVB (5th edition) were 83%, 70%, 45%, 23%, and 9%, respectively. These differences were significant (P < 0.0001). The survival rate for patients aged <60 years was significantly better (P < 0.05). The survival rate for patients aged >69 years was significantly worse (P < 0.01). The cholecystectomy plus combined resection of bile duct and/or liver bed resection had an effect on prolonging the survival in stage II or III disease, but extended resection did not. The patients with anomalous pancreaticobiliary ductal junction had a survival advantage over those with cholelithiasis by univariate analysis. However, multivariate analyses indicated that only age, sex, stage, operative procedures were independent prognostic factors. Stage was the strongest covariate; patients diagnosed with stage II, III, IVA, or IVB disease were 2.2, 4.2, 8.1, and 13.6 times, respectively, were more likely to die.

[Ann Surg 2008]

The Impact of Prophylactic Dexamethasone on Nausea and Vomiting After Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis.

Sat, 25 Oct 2008 02:52:54 -0400

The Impact of Prophylactic Dexamethasone on Nausea and Vomiting After Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis.:

Conclusions: Prophylactic dexamethasone decreases the incidence of nausea and vomiting after LC relative to placebo and may decrease the severity of postoperative pain. Dexamethasone does not increase the incidence of headaches or dizziness.

[Ann Surg 2008]

Operating Room Ventilation With Laminar Airflow Shows No Protective Effect on the Surgical Site Infection Rate in Orthopedic and Abdominal Surgery.

Sat, 25 Oct 2008 02:50:53 -0400

Operating Room Ventilation With Laminar Airflow Shows No Protective Effect on the Surgical Site Infection Rate in Orthopedic and Abdominal Surgery.:

Conclusions: Unexpectedly, in this analysis, which controlled for many patient and hospital-based confounders, OR ventilation with laminar airflow showed no benefit and was even associated with a significantly higher risk for severe SSI after hip prosthesis.

[Ann Surg 2008]

K-ras Mutations and Benefit from Cetuximab in Advanced Colorectal Cancer

Thu, 23 Oct 2008 04:32:37 -0400

K-ras Mutations and Benefit from Cetuximab in Advanced Colorectal Cancer:

Conclusions: Patients with a colorectal tumor bearing mutatedK-ras did not benefit from cetuximab, whereas patients witha tumor bearing wild-type K-ras did benefit from cetuximab (overall survival median, 9.5 vs. 4.8 months).The mutation status of the K-ras gene had no influence on survivalamong patients treated with best supportive care alone.

[NEJM 2008]