International journal of surgery
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To report the outcome of patients treated for colonic neoplasms using a laparoscopic assisted technique since its introduction at the University Hospital of the West Indies, Jamaica. ⋯ Appropriately selected patients with colonic neoplasms can be safely subjected to a laparoscopic assisted resection and expect to enjoy the advantages of this technique even in a developing country setting. The outcome of thirty consecutive laparoscopic assisted colectomies is reported demonstrating that this technique can be safely applied to selected patients with colonic carcinomas in developing countries.
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Surgeons are faced with the dilemma that many clinical questions in their daily practice to do not have universally agreed answers, but patients increasingly demand the 'best practice' from their doctors. In addition time pressures mean that clinicians are unable to keep up with the full spectrum of published research. We have adopted an approach first pioneered in emergency medicine, namely the Best Evidence Topic or Best BET. ⋯ Once the relevant papers are found, these papers are critically appraised, the relevant data to answer the question is extracted, tabulated and summarised. A clinical bottom line is reached after this process. The resulting BETs, written by practising surgeons can then provide robust evidence-based answers to important clinical questions asked during our daily practice.
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Randomized Controlled Trial Comparative Study
A prospective single center study to assess the impact of surgical stabilization in patients with rib fracture.
To compare the intensity of pain and duration of return to normal activity in patients with rib fractures treated with surgical stabilization with plating versus conventional treatment modalities. ⋯ Surgical stabilization of rib fracture, an underutilized intervention is better than conventional conservative management in terms of both, decrease in intensity of pain and early return to normal activity.
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Comparative Study Clinical Trial
DRUJ instability after distal radius fracture: a comparison between cases with and without ulnar styloid fracture.
Because of the importance of the DRUJ in upper extremity function and the prevalence of distal radius fractures, either with or without ulnar styloid fracture, this study was designed to assess the relationship between ulnar styloid fracture and the incidence of DRUJ instability after treatment of distal radius fractures treated with ORIF (volar plate). ⋯ Our study demonstrated that untreated stable or minimally displaced ulnar styloid fracture accompanied by distal radius fracture, has no adverse effect on DRUJ stability following ORIF of the radius.
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Review
Preoperative assessment of cardiac risk and perioperative cardiac management in noncardiac surgery.
More than 27 million Americans undergo noncardiac surgery annually. Cardiac complications can be a major source of morbidity and mortality in the perioperative period. ⋯ In this review we briefly describe the current evidence on perioperative management of patients presenting for noncardiac surgery. As the surgeon will remain one of the first to evaluate patients before noncardiac surgery it is essential he/she be well versed with this information.