A senior surgeon suggests that many commonly performed operations are not necessary and that any benefits they offer are a placebo. For many complaints and conditions the benefits from surgery are lower, and the risks higher, than you or your surgeon think. In this book you will see how commonly performed operations can be found to be useless or even harmful when properly evaluated. Of course no surgeon is recommending invasive surgery in bad faith, but Ian Harris argues that the evidence for the success for many common operations, including knee arthroscopies, back fusion or cardiac stenting, become current accepted practice without full examination of the evidence. The placebo effect may be real, but is it worth the recovery time, expense and discomfort?
"A groundbreaking medical memoir by one of our nation's leading pediatric surgeons - the visionary head of Children's National - for fans of Jerome Groopman and Atul Gwande. Anyone who has seen a child recover from a deep wound or a broken bone knows that kids are made to heal. Their bodies are more resilient, more adaptive, and far more able to withstand acute stress than adults. And yet children are often treated as an afterthought by the medical establishment and shunted off to doctors who specialize in treating adults. Will an anesthesiologist accustomed to treating older patients know how best to handle a toddler going under for the first time? If your soccer-playing daughter suffers a concussion, should you take her to the nearest ER--or drive further to seek out doctors who specialize in treating kids? In this deeply inspiring memoir Dr. Kurt Newman draws from his long experience as a pediatric surgeon working at one of our nation's top children's hospitals to make the case that children are more than miniature adults. Through the story of his own career and deeply moving accounts of the brave kids he has treated over the years (and their equally brave and determined parents) he reveals the revolution that is taking place in pediatric medicine"--
This video atlas covers a broad range of spinal surgical procedures. The volume includes a collection of high quality 3-to-8 minute videos of some of the most critical spine operations performed by internationally renowned expert surgeons. Key features of the book contents include: o Downloadable high quality video content with subtitles suitable for viewing on any display (A brief preview of the book content can be viewed at https://www.youtube.com/watch?v=SxMi4UFj7HA ) o Detailed descriptions of surgical indications, preoperative planning, patient positioning, surgical technique, complications, postoperative care and outcomes for each procedure o Full color images and illustrations highlighting different key stages of each surgical technique The video format allows skill development of its intended audience by conveying temporal and spatial details which often go unnoticed in photograph format. This volume will be of immense interest to both the novice and the experienced spinal surgeon as they can benefit from the visual guides presented in the book. It also serves as an ideal teaching tool for spine surgery units in medical schools.
In 2015, the Institute of Medicine (USA) issued a report critical of the research effort and clinical care for ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) formerly known as Chronic Fatigue Syndrome (CFS) and Chronic Fatigue Immune Deficiency Syndrome (CFIDS). While worldwide investigation into the cause and nature of ME/CFS remains disproportionately small, and treatment remains symptomatic and controversial, modest research continues in all aspects of this disease: epidemiology, possible infectious origins and other triggers, possible involvement of genetics, metabolism, and microbiome, influence of co-morbid conditions, and more. Treatment of patients consists of providing symptomatic relief. Guidance in doing so is provided for the clinician. School-age children require not only treatment but, as revealed in a 25-year retrospective study, continued engagement with peers and social activity. This e-book explores the breadth and depth of current ME/CFS research and clinical care. Its impact for other chronic, complex illnesses should not be overlooked.
This book provides state-of-the-art and up-to-date discussions on the pathology-related considerations and implications in the field of orthopaedic biomechanics. It presents fundamental engineering and mechanical theories concerning the biomechanics of orthopaedic and anatomical structures, and explores the biological and mechanical features that influence or modify the biomechanics of these structures. It also addresses clinically relevant biomechanical issues with a focus on diagnosis, injury, prevention and treatment. The first 12 chapters of the book provide a detailed review of the principles of orthopaedic biomechanics in the musculoskeletal system, including cartilage, bone, muscles and tendon, ligament, and multiple joints. Each chapter also covers important biomechanical concepts relevant to surgical and clinical practice. The remaining chapters examines clinically relevant trauma and injury challenges in the field, including diagnostic techniques such as movement analysis and rehabilitation intervention. Lastly it describes advanced considerations and approaches for fracture fixation, implant design, and biomaterials.
Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.
‘Represents the culmination of an 18-month-long project that aims to be the definitive review of this important topic. Accompanied by a scholarly literature review, some new analysis, and a wealth of evidence and insight... the report is a tour de force; a once-in-a-generation opportunity to take stock.’ – Dr Steven Hill, Head of Policy, HEFCE, LSE Impact of Social Sciences Blog ‘A must-read if you are interested in having a deeper understanding of research culture, management issues and the range of information we have on this field. It should be disseminated and discussed within institutions, disciplines and other sites of research collaboration.’ – Dr Meera Sabaratnam, Lecturer in International Relations at the School of Oriental and African Studies, University of London, LSE Impact of Social Sciences Blog Metrics evoke a mixed reaction from the research community. A commitment to using data and evidence to inform decisions makes many of us sympathetic, even enthusiastic, about the prospect of granular, real-time analysis of our own activities. Yet we only have to look around us at the blunt use of metrics to be reminded of the pitfalls. Metrics hold real power: they are constitutive of values, identities and livelihoods. How to exercise that power to positive ends is the focus of this book. Using extensive evidence-gathering, analysis and consultation, the authors take a thorough look at potential uses and limitations of research metrics and indicators. They explore the use of metrics across different disciplines, assess their potential contribution to the development of research excellence and impact and consider the changing ways in which universities are using quantitative indicators in their management systems. Finally, they consider the negative or unintended effects of metrics on various aspects of research culture. Including an updated introduction from James Wilsdon, the book proposes a framework for responsible metrics and makes a series of targeted recommendations to show how responsible metrics can be applied in research management, by funders, and in the next cycle of the Research Excellence Framework. The metric tide is certainly rising. Unlike King Canute, we have the agency and opportunity – and in this book, a serious body of evidence – to influence how it washes through higher education and research.
Frontiers in Tissue Engineering is a carefully edited compilation of state-of-the-art contributions from an international authorship of experts in the diverse subjects that make up tissue engineering. A broad representation of the medical, scientific, industrial and regulatory community is detailed in the book. The work is an authoritative and comprehensive reference source for scientists and clinicians working in this emerging field. The book is divided into three parts: fundamentals and methods of tissue engineering, tissue engineering applied to specialised tissues, and tissue engineering applied to organs. The text offers many novel approaches, including a detailed coverage of cell-tissue interactions at cellular and molecular levels; cell-tissue surface, biochemical, and mechanical environments; biomaterials; engineering design; tissue-organ function; new approaches to tissue-organ regeneration and replacement of function; ethical considerations of tissue engineering; and government regulation of tissue-engineered products.
Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US $10 billion per year. No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines. These new WHO guidelines are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
