{"title":"Test yourself: MCQ and Single Best Answer","authors":"Adrian Ben Cresswell","doi":"10.1016/j.mpsur.2024.10.001","DOIUrl":"10.1016/j.mpsur.2024.10.001","url":null,"abstract":"","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 11","pages":"Pages 857-858"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-melanoma skin cancer: diagnosis and current recommendations on management","authors":"Harriet S Walsh, Joseph Hardwicke","doi":"10.1016/j.mpsur.2024.08.007","DOIUrl":"10.1016/j.mpsur.2024.08.007","url":null,"abstract":"<div><div>The non-melanoma skin cancers (NMSC) basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) account for the vast majority of global skin cancer diagnoses. Although mortality rate is low, tumour burden can cause significant morbidity from local compression and invasion. Aetiological factors include external influences, namely exposure to UV radiation as well as other carcinogens and individual predisposition to susceptibility from these external factors. Management consists mainly of surgical excision or one of numerous non-surgical methods, the choice of which should be tailored to individual tumour and patient factors. Newer immunological therapies may have a role in advanced or refractory cases. Guidance for management of NMSC in the United Kingdom (UK) is provided by the British Association of Dermatologists.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 11","pages":"Pages 820-826"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Critical care chest radiology","authors":"Sara Scott, Ben Messer","doi":"10.1016/j.mpsur.2024.07.003","DOIUrl":"10.1016/j.mpsur.2024.07.003","url":null,"abstract":"<div><div>Before requesting any test, clinicians must consider how likely it is to be able to answer the clinical question. Multiple radiological investigations are available to aid diagnosis, assist with practical procedures and direct management of critically ill patients. This article gives an overview of commonly used thoracic imaging modalities and summarizes their indications, important findings and potential pitfalls.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 737-741"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Respiratory failure","authors":"Sneha Prasad, Suzanne O'Neill","doi":"10.1016/j.mpsur.2024.07.007","DOIUrl":"10.1016/j.mpsur.2024.07.007","url":null,"abstract":"<div><div>Respiratory failure is a common problem particularly in patients with pre-existing respiratory disease but also in previously well patients in the perioperative setting. It carries a 90-day mortality of above 40% representing a high-risk patient population. This article discusses the causes, presentation, assessment, and management of respiratory failure, along with a brief overview of perioperative risk prediction and pathophysiology.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 731-736"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sedation and delirium in the critically ill","authors":"Robert Whittle","doi":"10.1016/j.mpsur.2024.07.001","DOIUrl":"10.1016/j.mpsur.2024.07.001","url":null,"abstract":"<div><div>Sedation is used widely on critical care and is necessary to facilitate and alleviate the stress of invasive and potentially painful organ supportive therapies. Its use, however, is associated with morbidity and mortality. Treatments therefore need to be minimized and optimized wherever possible with overtreatment being avoided. It should be patient centred, with a focus of treating pain and agitation and delirium, common symptoms in critical care. Delirium itself is associated with morbidity and mortality and as such, all healthcare professionals involved with the care of the critically ill have a duty to identify, manage and minimize this distressing complication.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 765-770"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevention and management of acute kidney injury in the perioperative patient","authors":"Natalie Drury, Andrew Lewington","doi":"10.1016/j.mpsur.2024.07.008","DOIUrl":"10.1016/j.mpsur.2024.07.008","url":null,"abstract":"<div><div>Acute kidney injury should be regarded as a medical emergency and a biomarker of acute illness. It is detected by rises in serum creatinine or reductions in urine output and is a common and costly surgical complication, increasing length of stay, perioperative morbidity and mortality. Imperative to improving outcomes of patients with AKI is recognition of patients at risk, with the institution of preventative measures and the prompt treatment of those developing AKI. There are new therapies in the pipeline for AKI but in the interim the effectiveness of the application of a simple AKI care bundle should not be underestimated. The STOP AKI approach is centred on promoting better recognition of four key pillars in the management of AKI. These include treatment of Sepsis, stopping and avoiding Toxins, Optimization of blood pressure and fluid status and review Prescribing to include the treatment of complications.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 748-752"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of the circulation on the intensive care unit","authors":"Holly Speed, Gavin Hardy","doi":"10.1016/j.mpsur.2024.07.002","DOIUrl":"10.1016/j.mpsur.2024.07.002","url":null,"abstract":"<div><div>Mean arterial pressure (MAP) is a product of cardiac output (CO) and systemic vascular resistance. CO is calculated by multiplying stroke volume (SV) by heart rate. SV is determined by preload, cardiac contractility and afterload. These physiological parameters are targeted to manage blood pressure to maintain organ perfusion. In the hypotensive patient, assess fluid status and give intravenous (IV) crystalloid fluid resuscitation if appropriate. This optimizes the cardiac output, through an increase in end diastolic volume, based on the Frank–Starling law. If the patient's blood pressure is not fluid responsive, pharmacological intervention through inotropes, chronotropes and vasopressors may be required. A target MAP may be personalized based upon history and clinical examination. When the vasoactive intervention is escalating, cardiac monitoring may help guide further management. Mechanical circulatory support may be used in specialist centres. The hypertensive patient will be admitted to the intensive care unit (ICU) for invasive blood pressure monitoring and screening for end organ damage. Start by treating pain and anxiety. Regular oral antihypertensives may be continued if not contraindicated. IV antihypertensives in the form of beta blockers, calcium channel blockers and vasodilators may be started. Blood pressure is reduced in a controlled and rapid manner.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 753-758"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mechanisms of hypoxaemia and the interpretation of arterial blood gases","authors":"Mike Eager, Alex Nicoll, Robert Tipping","doi":"10.1016/j.mpsur.2024.07.004","DOIUrl":"10.1016/j.mpsur.2024.07.004","url":null,"abstract":"<div><div>While there are many causes for hypoxia, an appreciation of the underlying physiology will assist in the correct diagnosis and management of this condition. This article describes the normal delivery of oxygen to the tissues, conceptual mechanisms of hypoxia and the clinical relevance of these pathological processes. Interpreting arterial blood gases (ABGs) is an essential part of managing sick patients and a logical method of reading ABGs is presented, alongside examples of deranged ABGs and the conditions causing these changes.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 717-723"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Test yourself: MCQ and Single Best Answer","authors":"Adrian Ben Cresswell","doi":"10.1016/j.mpsur.2024.08.001","DOIUrl":"10.1016/j.mpsur.2024.08.001","url":null,"abstract":"","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 779-780"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Practical ventilator management","authors":"Rakesh Bhandary","doi":"10.1016/j.mpsur.2024.07.006","DOIUrl":"10.1016/j.mpsur.2024.07.006","url":null,"abstract":"<div><div>Mechanical ventilation is a common invasive intervention in intensive care units. While respiratory failure remains the most common indication for mechanical ventilation, the application and indications of this intervention are far more variable. Ventilation causes marked alteration to human physiology and is associated with complications and iatrogenic injuries. This article highlights practical aspects of patient management during invasive ventilation.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"42 10","pages":"Pages 742-747"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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