Surgery

Gynecomastia-the growth of breast tissue in men-can be an embarrassment for adolescents, but for professional bodybuilders it can be a career-ender. Two plastic surgeons said steroid use is to blame and surgery-not liposuction-is the best treatment.

Researchers at Huntsman Cancer Institute (HCI) at the University of Utah recently discovered the mechanism potentially triggering pancreatic cancer from the defects resulting from extrusion, the process through which cells are squeezed out of overcrowded tissue to die.

Renal clearance can be significantly elevated in the critically ill. Treating these patients with renally cleared drugs can present a problem. Drugs-whisked through the body with greater than expected efficiency, a process called augmented renal clearance (ARC)-reach only suboptimal levels and, consequently, patients experience no improvement or actual clinical decline. ARC is often associated with elevated urinary creatinine clearance.

In March 2014, the Society of Surgical Oncology Susan G. Komen for the Cure Symposium focused on the literature on the epidemiology, molecular pathology, and therapy considerations of triple-negative breast cancer. The Annals of Surgical Oncology has published a summary of this work ahead of print.

Facial fractures are a frequent cause for emergency department (ED) visits, costing the US economy about $1 billion every year. These fractures can occur due to a variety of traumas, including motor vehicle accidents, sports injuries, person-to-person violence, and falls. Identifying trends could help ED personnel and surgeons anticipate common problems.

Researchers recently used a 3-D printer to create case-specific models that can aid in accurate, extensive preoperative planning.

With so many changes in the health care industry, the days of doctors running solo practices in their hometowns seem to be ending as more physicians opt for employment with large health care systems.

The hospital shooting death of Boston cardiac surgeon Michael Davidson, MD, 44, has shocked the cardiology world-far beyond his colleagues at Brigham and Women's Hospital where he was director of endovascular cardiac surgery. On a remembrance page and in formal statements, tributes are pouring in. Davidson, a respected innovator in heart valve replacement, died late Jan. 20, hours after he was shot by the son of a former patient who then turned his gun on himself.He leaves his wife Teri Davidson, who is 7 months pregnant, and 3 children ages 2 to 9.

Ulnar collateral ligament reconstruction-or the Tommy John procedure as it's known to sports fans-has come a long way since its invention in 1974. It's not only a more refined procedure today, it's more popular.

Laparoscopic colorectal surgery (LCS) using multiple ports has become commonplace in colorectal surgery, offering a safe alternative to open surgery with similar surgical results. In other types of surgery, single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) are growing in popularity.

In the wake of Joan Rivers' untimely death last year, ambulatory surgery centers have come under increased scrutiny. Several recent articles in the literature look at this complicated area of surgical practice.

Researchers discovered defects in the Sox10 protein, a factor regulating gene expression, which evidently plays a role in developing post-operative gastrointestinal (GI) function in patients afflicted with Hirschsprung's disease.

Young baseball players experience alarming rates of arm pain and are often encouraged to play through it, according to findings published in the American Journal of Sports Medicine.

Surgical management of colon and rectum diseases changes quite quickly. Noting that many changes have been suggested in just the last year, 2 surgeons from the Mayo Clinic in Rochester, Minnesota, assembled a review of the most significant. This paper appears in the January 2015 issue of Current Opinions in Gastroenterology.

Fragmentation -- a lack of care continuity when disparate healthcare professionals provide care without integrated access to clinical information -- is a public health focus. It's a concern for surgeons when patients undergo complex procedures that require lengthy periods of recovery. Fragmentation is especially troubling when patients are elderly.

Surgeons from several leading medical schools in the United States gathered expert witness guidelines among major surgical societies for review. They looked for gaps in the standards to stimulate discussion about areas for improvement. Their review provides an educational look at the surgeon's role in the judicial system.

A new analysis of several prospective health studies indicates that low testosterone levels at any age are associated with an increased risk ischemic stroke in men.

Many health care organizations have started to lessen their environmental impact slowly by tackling small problems and making manageable changes. A multidisciplinary team of researchers from across the US carved out one surgical procedure to determine environmental impact. Their assessment of abdominal, vaginal, laparoscopic, and robotic hysterectomy appears ahead of print in the journal Environmental Science and Technology.

In many medical fields, malpractice has driven changes in the way physicians practice medicine. In the surgical field, tracheotomies are often crucial, but are associated with a high risk of morbidity and mortality. A quick look at the results when one enters "tracheotomy" and "lawsuit" into any search engine shows that patients, dissatisfied with myriad aspects of breathing through a tube, often sue after this procedure.

For patients diagnosed with knee osteoarthritis the pain associated not only with the condition but also the potential knee replacement surgery can be excruciating. A recent study looked at ways to minimize the pain after the operation to get people back on their feet as quickly as possible.

Postextubation dysphagia is a common but often unrecognized problem in critically ill patients who've been intubated for 2 days or more. Its causes include mechanical abrasion, cognitive disturbances, and the residual effects of narcotics and anxiolytic medications.

An article published electronically in JAMA Facial and Plastic Surgery discusses what happens when ears have been stretched beyond the body's ability to heal.

Atherosclerotic internal carotid artery disease is a major contributor to ischemic stroke. Surgeons use a combination of carotid artery and brain imaging to determine if patients have symptomatic carotid stenosis. However, there remains widespread disagreement on the threshold, timing, and best technical approach to carotid revascularization in symptomatic patients.

Slightly more than 6.8 million community-dwelling Americans use assistive devices (eg, canes, walkers, crutches) to help them with mobility and, of these, 1.7 million people use wheelchairs or scooter riders. These Americans at risk for unique musculoskeletal problems, especially rotator cuff injuries.

Since 2007, the American College of Surgeons National Surgical Quality Improvement Program database has tracked 30-day surgical outcomes and complications longitudinally.

Exhaustion, depersonalization, and perceived lack of personal accomplishment-these are the signs of burnout, a syndrome that decreases efficacy at work.

Spinal cord injury animal models were able to regain muscle function after a treatment with a peptide injection, according to study results published in Nature.

As electronic health records become more or less mandatory, the question moves from how widely they are adopted by practices across the country to whether the new versions are more effective than the old pen-and-paper way of doing business.

A 28 year-old commercial realtor comes to your office on Monday morning after spraining his right ankle in a basketball game with friends the preceding Saturday afternoon. He has a swollen right ankle with tenderness inferior and anterior to the lateral malleolus. He is limping but able to apply weight to the injured extremity.

Thymoma is rare and most known for its presence in 15% of patients who have myasthenia gravis. Thymoma tumors can be quite large. Surgery is the mainstay of treatment for thymoma, but when thymoma recurs (as it does in 10% to 30% of patients), the best course of action is often unclear.