Scot Med J
-
Takotsubo cardiomyopathy is the acquired, reversible syndrome characterised by apical ballooning and base hypercontractility and probably precipitated by emotional and physical stressors that cause a hyperadrenergic state. It presents as an acute coronary event without there being coronary disease. ⋯ To the author's knowledge, this is the first case of this syndrome occurring in such a prolonged septic process and where the primary focus was a surgical wound. This may indicate continued myocardial injury secondary to a sustained hyperadrenergic state as a possible mechanism for takotsubo cardiomyopathy, rather than a one-time catecholamine surge.
-
Review Comparative Study
A systematic review of plate versus intramedullary fixation in the treatment of midshaft clavicle fractures.
The best method of fixation for clavicle fractures is not known. The purpose of this review was to examine the evidence comparing plate and intramedullary fixation for midshaft clavicle fractures. A search of MEDLINE in September 2011 identified five papers that compared plate and intramedullary fixation, and fulfilled our eligibility criteria, consisting of; one randomised controlled trial, two quasi-randomised controlled trials, and two retrospective studies. ⋯ We found no difference between intramedullary fixation and plate fixation. There was a trend towards a lower complication rate with intramedullary fixation. On the basis of the available evidence, we would advocate both techniques for the treatment of midshaft clavicle fractures.
-
Review Case Reports
The conservative management of primary pyomyositis abscess in children: case series and review of the literature.
Pyomyositis is a primary pyogenic infection in skeletal muscle, often progressing to abscess formation. It is rare in temperate climates and generally deep-seated within the pelvis with non-specific clinical features, making diagnosis difficult. Magnetic resonance imaging (MRI) is highly sensitive for muscle inflammation and fluid collection, and with its increasing availability is now the investigation of choice. ⋯ Despite the organisms not being identified, each patient was treated successfully with a short (4-7 days) course of intravenous antibiotics followed by 2-6 weeks of oral therapy. There were no recurrences or complications and all made a full recovery. In conclusion, we propose that uncomplicated pyomyositis abscess in children may usually be managed conservatively without the need for open or percutaneous drainage.
-
The ability to acquire surgical skills requires consistent practice, and evidence suggests that many of these technical skills can be learnt away from the operating theatre. The aim of this review article is to discuss the importance of surgical simulation today and its various types, exploring the effectiveness of simulation in the clinical setting and its challenges for the future. Surgical simulation offers the opportunity for trainees to practise their surgical skills prior to entering the operating theatre, allowing detailed feedback and objective assessment of their performance. ⋯ Inorganic simulators comprise virtual reality simulators and synthetic bench models. Current evidence suggests that skills acquired through training with simulators, positively transfers to the clinical setting and improves operative outcome. The major challenge for the future revolves around understanding the value of this new technology and developing an educational curriculum that can incorporate surgical simulators.
-
Colorectal cancer ranks highly amongst all cancer sites in incidence and contributes to a substantial number of cancer related deaths in the United Kingdom. However, screening of average risk individuals has been shown to reduce both disease associated mortality and incidence. This paper provides an overview of both current and future screening methods for colorectal cancer, as well as current practice for screening in both average and high risk individuals.