A general surgeon gets trained in the basics of all surgical specialties. They will learn about anatomy, physiology, metabolism, immunology, nutrition, patholgy, wound healing, shock, resuscitation, intensive care, and neoplasia. A general surgeon also must learn to be able to diagnosis, learn the basics of preoperative, oberative, and postoperative management.
A general surgeon must learn how to deal with any complications that arise from surgery. The study of general surgery is going to cover nine components of surgery which include: the Alimnentary tract, Abdomen and it's contents, breast, skin, and soft tissue, head and neck including trauma, vascular, endocrine, congentital and oncologic disorders-primarily skin tumors, salivary glands, thyroid, parathyroid, and oral cavity., They would learn all about the vasular system which excludes the intracranial vessels and heart
A general surgeon also studies surgical oncology which includes screening, surveillance, surgical adjunctive therapy, rehabilitation, and follow-up of cancer patients. In "General Surgery" you will need to have a comprehensive management of trama of musculoskeletal, hand and head injuries. A general surgeon is responsible for care of an injured patient. They will need to provide complete care of critically ill patients in the emergency room, icu, and trama/burn units. You can go learn more information from the American board of Surgery.
]]>A foundation in San Diego, CA known as the Nuvasive Spine Foundation was able to bring Suleman to the United States. The Peyton Manning Children's Hospital in St. Vincent even volunteered to perform the extremely risky surgery pro bono.
She was suffering from a curve so severe that if you looked from behind, her hip and shoulder blade were actually touching. This doctors stated that her case of scoliosis was the most severe they had ever seen in all their 17 years working as a spinal surgeons.
"We typically operate on children if their curves are 45 to 50 degrees. If their curves are 25 to 30 degrees we put them in braces. She is only 12 and she was already suffering from a 170 degree curve," said Schwartz.
Schwartz was the surgeon who performed the almost 12-hour surgery. Suleman received 15 different levels of fusion during the surgery.
Just three short weeks after the surgery she is able to stand up straight, raise her arms and even walk without pain. The surgery has completely changed her outlook on life.
"I am happy," said Suleman. "I had lost hope but he brought it back."
Suleman will spend approximately one month undergoing rehab in San Diego and will then head home to Nairobi.
]]>Scientists from both John Hopkins University in Baltimore and Cedars-Sinai Medical Center in Los Angeles used cells grown from 17 patients to reverse the damage inflicted by their heart attacks. The researchers say that these safe procedures prove that a person's own cells can initiate new heart muscle growth as well as reduce scarring.
When someone experiences a heart attack, that person's heart is left with massive scarring. This scarred heart muscle tissue cannot pump blood as quickly as it did before. Furthermore, other parts of the heart must now help to circulate blood throughout the body, and this process places stress on these other parts of the heart that assist with this process. Since the damaged heart area can't properly conduct electrical currents, abnormal heart rhythms develop, which could potentially cause more heart problems, including heart failure.
Dr. Eduardo Marban, director of the Cedars-Sinai Heart Institute says that this process is the first example of therapeutic regeneration. Marban adds that many spontaneous regenerations of tissues and limbs abound in nature, such as a damaged human liver regrowing to its former full size, or a salamander growing a new tail after it has been severed. He goes on to explain that doctors have not previously been able to initiate therapeutic regeneration in heart patients, but that this could change soon if prolonged patient outcomes – and large-scale clinical trials – validate the results published Monday in the medical journal, The Lancet.
Marban, along with his colleagues, initially presented these findings in November at an American Heart Association conference.
Dr. Peter Johnson, one of the study's authors, said that to gain admittance into this clinical trial, recent heart attack sufferers had to have experienced a considerable amount of damage to their hearts. He also said that participants had to experience lessened squeezing of [blood into the body].
Twenty-five patients participated in this clinical trial held to ascertain the safety of growing cells from one's heart to be injected back into one's heart. Only 17 of these patients actually received the cell transplants, while the remaining eight patients underwent standard post-heart attack treatments.
In this outpatient study, the doctors overseeing the procedure inserted a catheter into each patient's heart, and took out peppercorn-sized pieces of tissue from the healthy portions of the patient's heart. Then, utilizing a procedure invented by Marban, the researchers isolated heart stem cells from the rest of the extracted tissue, and grew millions of new heart cells in a petri dish.
Roughly four to six weeks after the patients experienced the heart attacks, each one had from 12 to 25 million of their own cells derived from their hearts injected back into their hearts.
Marban says that when the initial, first patient's results came back, he and his colleagues were pleased to document that the procedure was safe. After one year, Marban's team reported that just one patient experienced a life-threatening side effect that might have been brought on by the experimental cell transfer.
Six months after the first patient received the treatment derived from the tissue in his own heart, new tissue had regenerated, and the patient experienced significant shrinking of his scar tissue, says Marban, who adds that this is an unprecedented event.
The researchers followed all of the patients for six months, and then continued to monitor 21 of the patients for one year. Half of the patients studied experienced a 50 percent decrease in their scar tissue, and an overall reduction in scar size, says Marban. However, Marban admits that he does not know why these findings occurred.
The amount of new heart tissue grown in the study participants was not small, says Marban, who cites an average of 78 ounces of new heart tissue found in each patient. He says these findings are quite extraordinary, since the section of the heart that pumps bloods is about 5.3 ounces.
Patients in the study that did not receive the heart cell transplants did not experience new tissue growth and their scarring remained exactly the same.
The deputy director of the NIH's National Heart, Lung, and Blood Institute's Division of Cardiovascular Sciences, Sonia Skarlatos, Ph.D., says this preliminary research is an exciting move forward. However, she says that much more research of this type needs to be performed on a lot more patients who should be monitored for longer periods than reported in the first study. She does admit that she is hopeful that the follow-up study's reports will confirm this first study's positive results.
Skarlatos says that through the prevention of heart attacks, you might prevent heart failure that occurs in many of these post-heart attack patients. She did not participate in the research, yet the National Heart, Lung and Blood Institute did fund the study.
Skarlatos adds that it is still unclear why the scar tissue disappeared and the heart tissue regenerated. Did the cells, the cell proteins or another factor contribute to these occurrences? Only further research will tell, she says.
We did witness a flash of hope during animal testing of this nature. However, human testing yielded much better results, says Marban, who adds that it usually does not transpire this way in medical research.
]]>Robotic surgery to remove a gallbladder via a single port was performed for the first time in the Midwest recently by surgeons at the University of Illinois at Chicago.
Gallbladder surgery (a cholecystectomy) using this method involves a single incision instead of multiple cuts and less scarring, according to Dr. Enrico Benedetti, head of the department of surgery at UIC.
In robotic surgery, the surgeon sits at a console operating joysticks that control the robot while its arms perform the actual surgery. The doctor sees the patient and every step of the procedure on various screens and can intervene immediately if necessary.
Dr. Pier Giulianotti, the surgeon at UIC who performed the robotic gallbladder removal, first began practicing robotic surgeries in 1999 and has since done hundreds of them.
The robotic surgeries are done at the University of Illinois Health & Sciences System, the renamed medical center at 1740 W. Taylor St.
“From the beginning I understood that the future of medicine would be connected to computers and robots,” Giulianotti said.
Gallbladder removal “is a very common procedure, performed half a million times in the United States a year,” Benedetti said.
Many of those patients are women for whom a procedure that reduces scarring is important.
Gallbladder removal used to involve conventional, open cavity surgery and then, in the late 1980s, the procedure started to be performed with laparoscopy, according to Dr. Benedetti. Laparoscopy involves inserting a camera into small incisions and then inflating the area with carbon dioxide to get a better view and perform the removal.
Gallbladder removal can be a recommended form of treatment for many gallbladder problems, according to the National Institutes of Health. The gallbladder stores bile from the liver.
A multi-port laparoscopy was the initial method used, but the focus has been on performing the operation with only a single port to reduce scarring. This can prove problematic when using laparoscopy, since all of the instruments are entering through a single port in the belly button in a straight alignment. Performing the operation with the robot can give the surgeon a better view of what he or she is doing.
Dr. Sherry Wren, professor of surgery at Stanford University, said that the single port surgery allows patients to avoid the three extra incisions and the robotic version of the single port surgery is better because of “the better viewpoint, ability to do better retraction, the ability to have a camera that isn’t colliding with your other instruments. It really reestablishes the ability to work in the safest manner on the gallbladder.”
Wren is a consultant for Intuitive Surgical, the California company that makes the robot (the da Vinci surgical system) used in the gallbladder removal. The robot is also used for surgical procedures involving various kinds of cancer, obesity, kidney disorders and uterine fibroids.
Benedetti pointed to the increased visibility robotic surgery provides for the surgeon as well as the fact that the robot filters out human hand tremors.
Criticism of the robot has centered on the price and practicality of having it at a hospital. Benedetti mentioned that Intuitive Surgical is the only company currently making the surgical robots. As competitors arise, the cost could potentially go down. Additionally, as the people becoming doctors are increasingly tech-savvy individuals, robotic surgery could itself become part of medical school training.
Dr. Marie Crandall, associate professor of surgery at the Northwestern University Feinberg School of Medicine, said that one area the robot still can’t be used is in trauma surgeries and that it would not be a good choice “when you need quick access to the abdomen for things like bleeding or intestinal spillage”
“I think it has the potential to be very helpful in minimally invasive applications where you need tremendous control over your instruments,” Crandall said.
Giulianotti called planning for the operating room of the future his “obsession” and mentioned improved patient comfort and understanding, converting to wireless, a central role for computers and robots and having a constant interface with surgeons in other locations as important.
He went on to say he thought surgery today was at the end of a 19th century process and that it was time to start at ground zero to reimagine the operating room.
Asked whether we’d ever see a completely automated surgery, he said, “I think the difference between the human mind and a computer is that the human mind can make errors. You can learn more and you can achieve also another step of knowledge. If you’re always repeating what you think is true, you’ll always stay at the same level.”
But until artificial intelligence can mimic the kinds of fortunate mistakes that lead to new discoveries, humans will still be needed for the surgical process, he said.
Source: A Midwest first - UIC surgeons perform robotic gallbladder removal via a single port (http://news.medill.northwestern.edu/chicago/news.aspx?id=198973) by Lisa Weidenfeld
]]>The AMA is offering a guide to assist in safely disposing of your medications. This guide will show you how to dispose of medications safely by keeping them out of local water and protect your children or adults from accidentally ingesting or misusing them.
"Many patients use prescription and over-the-counter medications as part of their health care routine, but if not properly disposed of these otherwise beneficial drugs can be extremely harmful," said AMA President Peter W. Carmel, M.D. "It is easy to accumulate expired or unneeded medications in a medicine cabinet, and Patient Safety Awareness Week provides an excellent opportunity to learn about the best way to get rid of these potential hazards."
The AMA also offers you tools to assist you with keeping records of all your medications and you can contact their physicians to answer your questions. Their medication safety checklist will assist you with keeping records of not only prescription medications but vitamins, your herbal, home remedies and alternative methods you may have read about. With all this information conveniently accumulated you can then supply them to your doctor. The AMA's MyMedications app, available on iTunes, will easily provide a place to file information on your medications, allergies and immunization records which can then be emailed to physicians and family.
"Patients with multiple conditions may see more than one prescribing physician and use other non-prescription medicines, so it is critically important to make sure these treatments are safe together," said Dr. Carmel. "The AMA encourages patients to discuss with their physicians all vitamins and medications, including prescription and over-the-counter, that they are currently taking. The medication safety checklist and MyMedications app provide great ways to start this important discussion and safely manage your medications."
]]>The AMA is worried that this is going to cause problems for people who are really in need of medical treatment. "Physicians, not health insurers, have the expertise to make decisions about which medications a patient should receive," AMA President Peter W. Carmel, MD, said in a news release. "Medicare patients who are seriously ill or in severe pain should not be unjustly denied the medications prescribed by their physician." The AMA agrees that misusing prescriptions is a serious problem but that CMS is not qualified to make the decision if someone is abusing their prescriptions or not.
The AMA offers a solution that drug plans provide claim information to physicians. They believe in a real-time prescription information for doctors and increased funds for drug-monitoring programs.
]]>Suggestions from the AMA include encouraging health insurers to fully share information so that prescribing physicians will know all of a patients' medications, increasing the funding for prescription drug monitoring programs, as well as for upgrades that provide real time prescription information to physicians at the point of care.
The AMA held strong in their beliefs that giving health insurers the ability to stop insuring medications prescribed by a physician is not the answer in dealing with the misuse of prescription drugs.
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