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The current interest in comparative effectiveness research, highlighted by the US Congress 2009 American Recovery and Reinvestment Act and the broader national debate about health care reform in the United States, is a welcome development for those with a long-standing interest in research on the effectiveness of health care interventions.
Archives of Surgery (Chirurgia generale) - Lun, 22 Febbraio 2010
http://archsurg.ama-assn.org/
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The editorial titled "For the Protection of the Public and the Good of the Specialty: Maintenance of Certification" (published in the February 2009 issue of the Archives of Surgery) has prompted us to offer the following article to inform the debate about how assessing surgical care and sorting out the variables to be included in maintenance of certification may develop worldwide. The proposals for revalidation of UK physicians involve the relicensing of all physicians and recertification of all specialists on the specialist register of the General Medical Council. The process will be on a 5-year cycle and is currently under development by the General Medical Council. The Royal Colleges have been charged with creating the standards for recertification, and the responsibility will fall on the Royal Colleges to support their fellows and members as the new regulation is introduced and as it develops. This article outlines developments so far, with particular reference to surgeons.
Archives of Surgery (Chirurgia generale) - Lun, 1 Febbraio 2010
http://archsurg.ama-assn.org/
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Surgeons who are burned out or depressed are more likely to say they had recently committed a major error on the job, according to the largest study to date on physician burnout. The new findings suggest that the mental well-being of the surgeon is associated with a higher rate of self-reported medical errors, something that may undermine patient safety more than the fatigue that is often blamed for many of the medical mistakes.
Johns Hopkins Hospital (Chirurgia generale) - Mar, 24 Novembre 2009
http://www.hopkinshospital.org
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Minimally invasive surgery is even more minimal now that doctors at Baylor College of Medicine are using only one incision for some procedures, leaving behind little to no scar. "This technique has been around for a couple of years. What we are doing now is expanding the types of surgeries for which we can use this method and understanding the benefits in a research setting," said Dr. Vadim Sherman , assistant professor of surgery and director of the Comprehensive Bariatric Surgery Center at BCM. Belly button One-incision surgeries use the same type of devices as traditional laparoscopic surgeries. However, instead of making up to four or more incisions in the stomach and abdomen area, only one is made through the belly button.
Baylor College of Medicine (Chirurgia generale) - Ven, 6 Novembre 2009
http://www.bcm.edu
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Although the US Food and Drug Administration requires new drugs to undergo rigorous premarket clinical trials, new surgical procedures are not regulated and may become widely used with little evidence of their safety or efficacy. Despite wide recognition of a greater need for evidence in surgery, a variety of practical and philosophical challenges have hampered use of randomized trials to test these interventions.
Journal of the American Medical Association (Chirurgia generale) - Ven, 16 Ottobre 2009
http://jama.ama-assn.org/
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The Lancet today is about surgery, but it is not just for surgeons. The issue addresses quality, innovation, and evaluation. These themes are taken up in a three-part Series from the Balliol Colloquia that introduces a framework for advancing surgical knowledge by translating innovations into practice. The need for standardised definitions and metrics is discussed by The Safe Surgery Saves Lives Measurement and Study Group. Two studies show the value of randomised controlled trials (RCTs) to inform surgical practice. Jeffrey Jarvik and colleagues compare complex non-surgical and surgical interventions for carpal tunnel syndrome, and Thomas Santarius and co-workers shine new light on one of the oldest surgical procedures—trephining.
The Lancet (Chirurgia generale) - Lun, 28 Settembre 2009
http://www.thelancet.com
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Giving critically ill hospital patients a daily bath with a mild, soapy solution of the same antibacterial agent used by surgeons to “scrub in” before an operation can dramatically cut down, by as much as 73 percent, the number of patients who develop potentially deadly bloodstream infections, according to a new study by patient safety experts at The Johns Hopkins Hospital and five other institutions.
Johns Hopkins Hospital (Chirurgia generale) - Lun, 7 Settembre 2009
http://www.hopkinshospital.org
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The subtle and not-so-subtle influence of industry on physicians has lately become a front-burner issue. Device makers and surgeons are coming under ever greater scrutiny. Although ventral, incisional, or inguinal hernia repair, with or without prosthetic material, is a fairly routine procedure, it is in fact one of the areas in need of greatest reassessment, in substantial part because of the massive associated hospital cost.
Archives of Surgery (Chirurgia generale) - Ven, 19 Giugno 2009
http://archsurg.ama-assn.org/
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The two most used techniques in bariatric surgery (obesity surgery) are the gastric banding (the banding of the first part of the stomach through silicone bandages), a technique prevalently used in Europe, and Roux-en-Y bypass (surgical intervention to connect esophagus to duodenum), a technique prevalently used in the USA.
MedNews (Chirurgia generale) - Ven, 17 Aprile 2009
http://mn.medsurfnews.com/
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Laparoscopic incisional hernia repair in solid-organ transplant recipients is associated with a high rate of seroma formation but minimal long-term morbidity. The recurrence rate after LIHR is equivalent to that after open hernia repair. These results suggest that LIHR is a safe and effective alternative to open repair in this patient population.
Archives of Surgery (Chirurgia generale) - Ven, 3 Aprile 2009
http://archsurg.ama-assn.org/