International journal of surgery
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Comparative Study
Larger hepatic metastases are more frequent with N0 colorectal tumours and are associated with poor prognosis: implications for surveillance.
Surgery is the treatment of choice for colorectal cancer liver metastases (CLM). The aim of our study was to analyze which clinical and pathological risk factors can predict recurrence after liver resection. ⋯ We demonstrated a positive correlation between N0 primary tumour and large liver metastases, which have a higher risk of disease recurrence. If validated in larger, independent studies, this study would suggest routine imaging surveillance follow up of even N0 colorectal tumours, until the biology of these tumours is fully understood.
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Caring for patients in traditionally designed, large teaching hospitals is often frustrating. Attempts at decreasing internal costs and inpatient length of stay are universally undertaken in order to address dwindling reimbursement, and patient care becomes more specialized and fractionated. These attempts have proven to be myopic, at best, and injurious to patient care and professional job satisfaction, at worst. This manuscript attempts to characterize the operational processes of our university operating room facility as well as make suggestions for operational improvements that can be applied to all hospitals. ⋯ Nowhere in the hospital is this drive for cost containment and increased patient volume more evident than in the operating theatre. Long-term improvements must embrace radical reduction of OR costs and increased operative patient through-put, (i.e. per 8 h day; per fiscal year) by re-engineering the processes of operative patient care. In the end, the ultimate goal of safe and high-quality patient care must not be compromised.
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Case Reports
Case series and literature review: popliteal artery injury following total knee replacement.
We present a case series and literature review of injury to the popliteal vessels during total knee replacement (TKR). This is rare but may be limb-threatening with devastating consequences for the patient. An individual surgeon will see few cases. ⋯ Incidence remains steady. More careful surgical technique may be the most effective preventative measure. Ongoing awareness is therefore essential for early diagnosis and management of this rare but serious complication.
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Comment Letter Meta Analysis
Complementary and alternative medicine (CAM) and cancer: the kind face of complementary medicine.
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To ascertain the influence of images depicting different qualities of pain on unselected outpatient pain clinic consultations. ⋯ The results suggest that introducing a focus of images of pain into unselected pain consultations can facilitate discussion and lead to more fruitful dialogue between patients and clinicians.