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Journal of the Royal College of Surgeons of Edinburgh最新文献

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The management of sigmoid volvulus. 乙状结肠扭转的治疗。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
T E Madiba, S R Thomson
{"title":"The management of sigmoid volvulus.","authors":"T E Madiba,&nbsp;S R Thomson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The epidemiology and clinical pattern of sigmoid volvulus are well defined. Although clinical manifestations of acute volvulus are often clear-cut, diagnostic doubt is not uncommon and, if gangrene supervenes, mortality rises appreciably. While gangrene requires resectional surgery, the management of the viable colon related to a volvulus episode has a variety of options. These, particularly non-resectional alternatives, require more critical reappraisal in the light of advances in minimally invasive techniques.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"74-80"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667877","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}
引用次数: 0
Revalidation: the catalyst for change in continuing professional development? 重新验证:持续专业发展变化的催化剂?
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
A J McKay
{"title":"Revalidation: the catalyst for change in continuing professional development?","authors":"A J McKay","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Remarkably, only five years ago, hospital specialists were under no formal obligation to record participation in Continuing Medical Education (CME). No one seriously doubted that such education took place, but the system had never been challenged. In recent years, and with apparently ever increasing pace, all this is changing. Traditional, didactic, lecture based teaching of undergraduates is slowly vanishing from many undergraduate curricula. Postgraduate hospital training has been brought into line with Europe so that, within 7 years of full registration, it is theoretically possible to become a consultant. The Royal Colleges were charged with developing and monitoring a structured system of CME and chose to use the \"points\" system of which there was experience elsewhere. Around 70% of surgeons returned their annual CME forms and almost all met the agreed minimum points total. As a meaningful educational exercise which impacted favourably on patient care the points system was impossible to defend vigorously, and was ignored by an important minority. More recently still, our entire profession has been exposed to regular and fundamental criticism. There was a real risk that we would lose the right to self regulation. The GMC has now announced that every doctor will be required to undergo a process of appraisal that will lead to revalidation, allowing the doctor to remain on the national register. A full consultative process is now in place, with the Royal Colleges being required to implement a new system of annual review which will allow profiling of every surgical practice. While it is possible react to these changes with a combination of resentment and paranoia, the profession should grasp this opportunity for change. The sensible introduction of personal portfolios should allow us to maintain and improve standards of care, and allow us to demonstrate these standards to our peers, our employers and our patients. We may yet look back on clinical governance and revalidation as the catalysts which brought about constructive change to a potentially complacent profession.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"71-3"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21668004","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}
引用次数: 0
Flap repair: an effective strategy for minimising sexual morbidity associated with the surgical management of vulval intra epithelial neoplasia. 皮瓣修复:一个有效的策略，以减少与外阴上皮内瘤变手术管理相关的性发病率。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
G V Narayansingh, G P Cumming, D P Parkin, D T McConell, E Honey, P S Kolhe
{"title":"Flap repair: an effective strategy for minimising sexual morbidity associated with the surgical management of vulval intra epithelial neoplasia.","authors":"G V Narayansingh,&nbsp;G P Cumming,&nbsp;D P Parkin,&nbsp;D T McConell,&nbsp;E Honey,&nbsp;P S Kolhe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To assess the sexual function after local excision and flap repair for symptomatic vulval intraepithelial neoplasia (VIN).</p><p><strong>Study design: </strong>A retrospective analysis of five sexually active women who had persistent, symptomatic VIN diagnosed in a dedicated tertiary referral vulval clinic and treated with local excision and flap repair. Sexual function was assessed using a modified version of the Sabbatsberg Sexual Self-Rating Scoring (SRS) system.</p><p><strong>Results: </strong>The mean age of the cohort was 32 years (range 30 to 51). Four patients had previously been unsuccessfully treated with local excision. Follow up ranged from 5 to 33 months. The SRS scores were 90, 90, 81, 72 and 25. Endogenous depression may explain this last score. There has been no recurrence of VIN.</p><p><strong>Conclusion: </strong>In sexually active women with symptomatic VIN III, a flap reconstruction should be considered in addition to local excision as the treatment of choice.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"81-4"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667878","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}
引用次数: 0
Internet mailing lists: a primer. 互联网邮件列表:入门。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
S Prasad
{"title":"Internet mailing lists: a primer.","authors":"S Prasad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The widespread availability of new electronic sources of information has exponentially increased the amount of information available to the surgeon in recent years. These new sources of information come in various forms, each of which have their own rules and regulations. This article focuses on Internet mailing lists. The practicalities of mailing lists are discussed, with guidelines to help users find lists of interest, join and contribute to, and use this medium effectively while minimising the time spent on it. Pointers to starting one's own list are provided for the motivated reader.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"122-6"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667884","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}
引用次数: 0
Screening for early prostate cancer: what is the problem? 早期前列腺癌筛查:问题是什么?
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
L Moffat
{"title":"Screening for early prostate cancer: what is the problem?","authors":"L Moffat","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Screening has been applied to normal populations to detect early cancers. Prostate cancer is very common and can be detected at an early stage. Screening has not been introduced in the UK for this disease and the possible reasons for this are discussed. There is a strong case for evaluation of screening programmes for this disease.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"127-31"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667885","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}
引用次数: 0
Laparoscopic anterior fundoplication. 腹腔镜前眼底折叠。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
A Munro
{"title":"Laparoscopic anterior fundoplication.","authors":"A Munro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Laparoscopic fundoplication has become the standard surgical method of treating gastro-oesophageal reflux disease. Although Nissen total fundoplication is the most commonly performed procedure, partial fundoplication, either anterior or posterior, is becoming more acceptable because of a suggested lower risk of long term side effects. This article describes a technique of laparoscopic anterior fundoplication.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"93-8"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667880","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}
引用次数: 0
Mycobacterium tuberculosis presenting as sternal osteomyelitis. 结核分枝杆菌表现为胸骨骨髓炎。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
K J Stewart, O A Ahmed, R B Laing, J D Holmes
{"title":"Mycobacterium tuberculosis presenting as sternal osteomyelitis.","authors":"K J Stewart,&nbsp;O A Ahmed,&nbsp;R B Laing,&nbsp;J D Holmes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 54-year-old female presented with a presternal abscess and developed axillary lymphadenopathy. Imaging confirmed the presence of sternal osteomyelitis. The osteomyelitis was cured by resection and muscle flap reconstruction. Although tuberculosis was suspected, the organism was only cultured after the fourth surgical procedure. Surgeons should be aware that negative microbiology does not exclude a diagnosis of Mycobacterium tuberculosis.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"135-7"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667887","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}
引用次数: 0
Hepatic malignancy: challenges and opportunities for the surgeon. 肝恶性肿瘤:外科医生的挑战与机遇。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
V Usatoff, N Habib
{"title":"Hepatic malignancy: challenges and opportunities for the surgeon.","authors":"V Usatoff,&nbsp;N Habib","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The management of hepatic malignancy has changed from a previously nihilistic approach to a more positive one. Every patient should be considered for curative surgical resection, either at first presentation or after cytoreductive treatment. The surgeon is faced with the challenge of adapting modern surgical techniques to increase resectability rates. Although the majority of patients are unsuitable for resection, effective palliation can be achieved using a wide variety of techniques. The rational implementation of these palliative modalities requires a multidisciplinary approach which provides the surgeon with the opportunity to play a key role in the ongoing management of these patients.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"99-109"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667881","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}
引用次数: 0
Metastasising dermatofibroma or dermatofibroma-like dermatofibrosarcoma protuberans? 转移性皮肤纤维瘤还是皮肤纤维瘤样皮肤纤维肉瘤隆突?
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
C S Dunkin, A B MacGregor, K McLaren
{"title":"Metastasising dermatofibroma or dermatofibroma-like dermatofibrosarcoma protuberans?","authors":"C S Dunkin,&nbsp;A B MacGregor,&nbsp;K McLaren","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dermatofibroma is a relatively common cutaneous fibrohistiocytic tumour with a marked tendency to recur locally. It is almost invariably benign. In a review of the world literature there was one report of two patients with dermatofibroma with histologically documented metastases. In both of these there was local recurrence and subsequent metastasis to lymph nodes and haematogenous spread to the lungs. We present a case of cellular dermatofibroma of the lower limb with local recurrence and metastasis to the abdominal wall, posterior chest wall and both lungs 30 months after excision of the primary lesion. The clinical and pathological features of the case are presented to emphasis the need for follow up of patients with dermatofibroma which present any unusual histological features.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"132-4"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21667886","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}
引用次数: 0
Local anaesthesia: to warm or alter the pH? A survey of current practice. 1999; 44(3): 167-71. 局部麻醉:加热或改变pH值?对当前实践的调查1999;44(3): 167 - 71。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-04-01
P W Baxter
{"title":"Local anaesthesia: to warm or alter the pH? A survey of current practice. 1999; 44(3): 167-71.","authors":"P W Baxter","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 2","pages":"140"},"PeriodicalIF":0.0,"publicationDate":"2000-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21668988","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}
引用次数: 0
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