Articles
Many Livers 'Too Fat' For Transplant
July 25, 2012 6:37 am | by Kristina Fiore | CommentsIncreases in factors associated with fatty liver disease may be leading clinicians to discard more donated organs, researcher found. In an analysis of data from the United Organ Sharing Network (UNOS), age, obesity, diabetes, and hypertension were associated with an increased risk of a liver being discarded, Eric Orman, MD, of the University of North Carolina at Chapel Hill, and colleagues reported during a press briefing at Digestive Disease Week here.
The Role Of IVs And Central Lines In Critical Care
July 25, 2012 5:58 am | by Mark E. Nunnally | CommentsAs a critical care anesthesiologist, I care for patients when they are most vulnerable. Critical care patients require intravenous (I.V.) fluids and medications, frequently through central venous access. These are catheters inserted into larger veins with a special procedure. I believe managing I.
Why Can't Medicine Seem To Fix Simple Mistakes?
July 23, 2012 6:58 am | CommentsNYU's Langone Medical Center announced this week that it was adopting new procedures after the death of a 12-year old boy from septic shock. The hospital's emergency room sent Rory Staunton home in March and then failed to notify his doctor or family of lab results showing he was suffering from a raging infection.
Over-thinking Laparoscopic Surgery Training
July 23, 2012 6:46 am | CommentsAre we over-thinking the training of residents in minimally invasive surgery? Two recent papers in prominent surgical journals suggest to me the answer is “Yes.” In the July 2012 issue of Surgery, a paper entitled “Cheating experience: Guiding novices to adopt the gaze strategies of experts expedites the learning of technical laparoscopic skills” investigated whether teaching novices to perform simulated tasks on a laparoscopic surgery training system by using the gaze strategies of experts would improve performance.
How To Be The Bearer Of Bad News
July 20, 2012 11:05 am | CommentsDoctors, unfortunately, have little training in how to deliver bad news. But it's a critically important aspect of a physician's responsibility -- one that has tremendous impact on patients. Cardiologist Kevin Campbell offers some tips, including using a structured process to deliver bad news to patients.
Distractions In OR Make Errors More Likely
July 20, 2012 10:55 am | CommentsSurgery residents committed eight times as many errors during simulated procedures when realistic distractions and interruptions were introduced than when they completed procedures without interruption, investigators reported. The residents made major surgical errors during eight of 18 simulated procedures with distractions versus only one of 18 operations that occurred without intrusions.
TAVI, Surgery Both Improve Health Status
July 20, 2012 4:40 am | CommentsFor patients with symptomatic severe aortic stenosis who are at high risk for surgical complications, both transcatheter aortic valve implantation (TAVI) and surgical replacement dramatically improve health status within 1 year, an analysis of the PARTNER trial showed. By 1 year, the gains seen in each group were similar, although in the shorter term TAVI performed using the transfemoral approach -- but not the transapical approach -- led to more rapid improvement compared with surgery, according to David Cohen, MD, of Saint Luke's Mid America Heart Institute in Kansas City, Mo.
Why I Wear A White Coat
July 20, 2012 4:37 am | CommentsA recent article in a major newspaper asked why physicians still wear white coats. The theme echoed many recent stories of bacterial contamination of clothing and other inanimate objects. Despite published papers reporting the existence of bacteria on white coats and ties, the UK policy was not based on any evidence linking coats, ties or long sleeves to transmission of infection to patients.
Boy Scrapes Arm During Gym Class, Dies Days Later
July 19, 2012 8:54 am | CommentsThis past spring, Rory Stauton, 12, got a minor scrape on his arm during gym class. Four days later, he died of toxic shock syndrome. TODAY's Savannah Guthrie reports and speaks with Rory's parents, Orlaith and Ciaran Stauton, who say doctors could have done more to save him.
Shank Through Neck Nearly Hits Spinal Cord
July 19, 2012 8:38 am | CommentsA Massachusetts prison guard is lucky to be alive after an inmate stabbed him in the neck.
How Much Does Surgery Cost? About $147 A Minute
July 17, 2012 4:47 pm | by Nate Johnson | CommentsThe patient had a large abscess surrounding his spleen. On a large screen in the middle of the operating room, I watched a surgeon drain the fluid collection and remove the organ with small metal tools. I remember the surgeon navigating the complex anatomy with alacrity, handling the laparoscopic equipment with expert finesse, and quickly and confidently answering the battery of questions from the assisting medical student.
For Tiniest Patients, Fetal Surgery Delivers Big Results
July 17, 2012 4:32 pm | by Joseph Brownstein | CommentsOn Nov. 7, 2006, Mary Kelly went for a routine pregnancy ultrasound. Three days later, she and her unborn daughter had become pioneers. Kelly and her daughter, Addison, now 5 years old, were the second mother and child to undergo a fetal surgery procedure where doctors removed a tumor between the heart and lungs that was causing heart failure and fetal hydrops — a condition where Addison was taking on so much fluid that she would not likely survive.
OK To Operate For Gallstones Without Waiting
July 17, 2012 7:05 am | by Crystal Phend | CommentsIn patients with gallstone pancreatitis, the common practice of delaying surgery until laboratory values stabilize lengthens the hospital stay without benefit to patients, an observational study determined. Surgery within 48 hours of admission regardless of liver and pancreatic enzyme levels didn't significantly raise complication rates, conversion from laparoscopic to open surgery, or need for postoperative endoscopic procedures, Darin J.
Puzzling Things About Surgical Education
July 17, 2012 6:57 am | CommentsWhen I was a surgical residency program director, I often wondered what the establishment, you know those guys who ran surgical education, were thinking. Some may remember the rule that a resident had to see at least 50 percent of the patients he operated on in the clinic or the private surgeon’s office in order to claim credit for having done the case.
