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Academic literature on the topic 'General surgery – ethics'

Author: Grafiati

Published: 29 July 2024

Last updated: 31 July 2024

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Journal articles on the topic "General surgery – ethics"

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Wall, Anji, Peter Angelos, Douglas Brown, Ira J. Kodner, and Jason D. Keune. "Ethics in Surgery." Current Problems in Surgery 50, no. 3 (March 2013): 99–134. http://dx.doi.org/10.1067/j.cpsurg.2012.11.004.

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&NA;. "Ethics and Craniofacial Surgery." Journal Of Craniofacial Surgery 11, no. 1 (January 2000): 3–9. http://dx.doi.org/10.1097/00001665-200011010-00002.

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Kwak, Christine B. "Practical Ethics: A Medical Student’s Ethical Case in Surgery Clerkship." Journal of Clinical Ethics 34, no. 3 (September 1, 2023): 282–84. http://dx.doi.org/10.1086/726810.

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Gligorov, Nada, Pippa Newell, Jason Altilio, Mike Collins, Amanda Favia, Leah Rosenberg, and Rosamond Rhodes. "Dilemmas in Surgery: Medical Ethics Education in Surgery Rotation." Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine 76, no. 3 (May 6, 2009): 297–302. http://dx.doi.org/10.1002/msj.20110.

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Baldi, Djullian, and Giovana Elisa Rosa Galiassi. "GENERAL SURGERY IN PALLIATIVE PATIENTS: CHALLENGES, ETHICS AND QUALITY OF LIFE." International Journal of Health Science 3, no. 102 (December 18, 2023): 2–4. http://dx.doi.org/10.22533/at.ed.159310223151210.

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Meyers, Arlen D. "Facial Plastic Surgery Web Site Ethics." Archives of Facial Plastic Surgery 3, no. 1 (January 1, 2001): 58–60. http://dx.doi.org/10.1001/archfacial.qep00001.58.

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Malik, Anita, and Usha Saha. "Ethics in Neonatal Anesthesia – A Tender Perioperative Care." Journal of Neonatal Critical Care and Anesthesia 1 (March 15, 2024): 3–5. http://dx.doi.org/10.25259/jncca_7_2023.

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Medical ethics, a set of norms and values applied to the behavior of medical care personnel, has been evolving along with the scientific and technical development in the field of neonatology, surgery, and anesthesia. Regarding the anesthetic management of a neonate, an anesthesiologist is always in an ethical dilemma. On one side, anesthesia is a necessity for surgery, and on the other hand, knowing that these interventions may have untoward or adverse effects. Autonomy, nonmaleficence, beneficence, and justice are the four basic principles of medical ethics, which are used in harmony with each other without any order of succession and along with virtues of compassion, integrity, honesty, truthfulness, and fairness provides an ethical decision-making framework for a tender perioperative care. Professionalism in the operating room and anesthesiologist – surgeon relationship is an integral part of the ethical concerns in neonatal anesthesia.

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Hanlon, C. Rollins. "Surgical ethics." American Journal of Surgery 187, no. 1 (January 2004): 1–2. http://dx.doi.org/10.1016/j.amjsurg.2003.09.007.

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Twomey, John G. "The Ethics of In Utero Fetal Surgery." Nursing Clinics of North America 24, no. 4 (December 1989): 1025–32. http://dx.doi.org/10.1016/s0029-6465(22)01562-6.

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Dwarswaard, J., M. Hilhorst, and M. Trappenburg. "The robustness of medical professional ethics when times are changing: a comparative study of general practitioner ethics and surgery ethics in The Netherlands." Journal of Medical Ethics 35, no. 10 (September 30, 2009): 621–25. http://dx.doi.org/10.1136/jme.2009.029892.

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Books on the topic "General surgery – ethics"

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David, Benatar, ed. Cutting to the core: Exploring the ethics of contested surgeries. Lanham, Md: Rowman & Littlefiels, 2006.

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Ritter, Thomas J. Say no to circumcision!: 40 compelling reasons why you should respect his birthright and keep your son whole. Aptos, CA: Hourglass Book Pub., 1992.

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Ritter, Thomas J. Say no to circumcision!: 40 compelling reasons why you should respect his birthright and keep your son whole. 2nd ed. Aptos, CA: Hourglass Book Pub., 1996.

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1964-, Clarke Steve, and Oakley Justin 1960-, eds. Informed consent and clinician accountability: The ethics of report cards on surgeon performance. Cambridge: Cambridge University Press, 2007.

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Beckmann, Jan P. Xenotransplantation von Zellen, Geweben oder Organen: Wissenschaftliche Entwicklungen und ethisch-rechtliche Implikationen. Berlin, Heidelberg: Springer Berlin Heidelberg, 2000.

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Gawande, Atul. Better: A surgeon's notes on performance. New York: Picador, 2008.

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E, Starzl Thomas. The puzzle people: Memoirs of a transplant surgeon. Pittsburgh: University of Pittsburgh Press, 1992.

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Lock, Margaret M. Twice dead: Organ transplants and the reinvention of death. Berkeley, CA: University of California Press, 2002.

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Murad, Alam, ed. Cosmetic dermatology for skin of color. New York: McGraw-Hill Medical, 2009.

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Sade, Robert M. Ethics of Surgery: Conflicts and Controversies. Oxford University Press, Incorporated, 2014.

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Book chapters on the topic "General surgery – ethics"

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Bernstein, Eric R., and Zita Lazzarini. "Medicolegal and Ethical Considerations in Oral Surgery by the General Dentist." In Evidence-Based Oral Surgery, 103–25. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-91361-2_6.

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Romero, Margarida, Jonathan Reyes, and Panos Kostakos. "Generative Artificial Intelligence in Higher Education." In Palgrave Studies in Creativity and Culture, 129–43. Cham: Springer Nature Switzerland, 2024. http://dx.doi.org/10.1007/978-3-031-55272-4_10.

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AbstractGenerative Artificial Intelligence (GAI) has become popular recently with the advances in text and image generation tools (e.g., ChatGPT) that are easy to use for the general public. The emergence of GAI has sparked a surge in academic studies within higher education (HE) but also raised concerns about the changes related to policy making. This chapter analyses the impact of GAI on HE, addressing its uses in language learning, chatbot applications, and responsible AI implementation. Evaluating both its benefits and limitations, this chapter navigates through diverse studies, presenting insights into GAI's potential in education, while emphasising the need for responsible deployment and ethical considerations.

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Montalto, Andrea, and Francesco Musumeci. "Innovation and Research in Cardiac Surgery: Bioethical Aspects." In Bioethics in Medicine and Society. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.94160.

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Significant advancements have been made in Cardiac surgery during the last decades, thanks to technological evolution. The enormous progress achieved has led to a relevant improvement in terms of surgical results, and at the same time, new ethical dilemmas have been addressed. Until the 90’s ethics in cardiac surgery mainly concerned significant moral problems caused by the introduction of extremely innovative techniques. However, today’s ethical issue focuses essentially on the doctor-patient relationship, other aspects of doctor’s practice concern relevant ethical perspectives. Ethics affects today the activity of the surgeon and the doctor in general. It is possible to distinguish clinical ethics, an ethics of health policies, and scientific research ethics. In the following chapter, we try to analyze the main ethical aspects concerning the application of cardiac surgical procedures.

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Fenton, Oliver. "The ethics of gender reassignment surgery." In Oxford Textbook of Plastic and Reconstructive Surgery, edited by Simon Kay, 1573–76. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780199682874.003.0131.

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Transgender issues are very much in the news at present. There has been discussion about both gender dysphoria in general but, more specifically, the practical, psychological, and financial implications of carrying out gender reassignment surgery. In the United Kingdom, this extends to a debate on whether it is justifiable to carry out these procedures within an already hard-pressed National Health Service. This chapter discusses the nature, history, and background of both gender dysphoria and gender reassignment surgery and whether such procedures are justifiable in terms of outcomes and patient satisfaction; and also whether these are legitimate procedures to carry out within the National Health Service.

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Konstantopoulos, Nektarios, Vasileios Syrimpeis, Vassilis Moulianitis, Ioannis Panaretou, Nikolaos Aspragathos, and Elias Panagiotopoulos. "A Smart Card Based Software System for Surgery Specialties." In Healthcare Ethics and Training, 394–409. IGI Global, 2017. http://dx.doi.org/10.4018/978-1-5225-2237-9.ch017.

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This chapter presents a software system based on smart cards technology for recording, monitoring and studying patients of any surgery specialty (General Surgery, Orthopedics, Neurosurgery, etc.). The system is also suitable for the computerization of any surgery specialty clinic and the respective surgical material repositories. Dynamic customization functions adapt the system to the different characteristics of the surgery specialties. Special customization is involved concerning implantable materials. The .NET platform and Java Cards used for the development of the system and the architectural model of the system are designed towards satisfying the basic integration and interoperability issues. The developed system is “doctor-friendly” because it is based on classifications and knowledge grouping used in every day clinical practice provided from medical experts on the field but is not intended to be a complete Electronic Medical Record (EMR). The major scope of this effort is the development of a system that offers a fast and easy installable, low cost solution in health environments still immature in adopting solutions based exclusively on Informatics and is designed to be installed in small Private Medical Consulting Rooms to Community Clinics, Health Centers, Hospital Surgery Departments till Central Health Organizations.

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Ghotbi, Nader. "The Ethics of Medical Tourism." In Current Issues and Emerging Trends in Medical Tourism, 79–88. IGI Global, 2015. http://dx.doi.org/10.4018/978-1-4666-8574-1.ch006.

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Medical tourism is rapidly growing. There are various reasons for this form of travel; from having life-saving surgery, receiving organ transplants and other vital operations, to therapeutic massage, using hot spas, and cosmetic surgery, and from receiving assistance with infertility to assisted suicide services at particular destinations. Some forms of medical tourism have strong ethical issues attached to them, but there are also ethical issues that may apply to almost all cases, and these can be discussed in a general way. This chapter discusses fundamental definitions of the concepts and general ethical issues in medical tourism, and then explains in more detail some of the moral issues in medical tourism that need to be examined from an ethical standpoint. The chapter establishes common ground for discussion based on broadly accepted principles that can be used almost universally as general guidelines for ethical decision-making in medical tourism activities.

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Smajdor, Anna, Jonathan Herring, and Robert Wheeler. "Ethico-legal issues by medical specialism A–M." In Oxford Handbook of Medical Ethics and Law, edited by Anna Smajdor, Jonathan Herring, and Robert Wheeler, 229–60. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780199659425.003.0022.

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This chapter covers Ethico-legal issues by medical specialism and includes topics on the following subjects (A-M): Anaesthetics: Child refusing treatment, Cardiac Surgery: Candour, Dentistry: Gillick Competence, Dermatology; a right to treatment?, Diabetology: Maintaining clinical records, Elderly Care: Refusal of Treatment, Emergency Department: Knife Crime, Emergency Department: Restraint/Self-Defence, Endocrinology: Wishes/Feelings, ENT: Consent/Necessity, Family Planning: Gillick Competence, Gastroenterology: Mental Health Act, General Practice: Cultural Circumcision, General Surgery: Need for clinicians to keep up to date, Genetics: Confidentiality, Gynaecology: abortion, HIV: Confidentiality, Intensive Care: DNACPR, Interventional Radiology: Relative Risks, and Maxillofacial: Candour.

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Hare, R. M. "Medical Ethics Can the Moral Philosopher Help?" In Essays On Bioethics, 1–14. Oxford University PressOxford, 1993. http://dx.doi.org/10.1093/oso/9780198239833.003.0001.

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Abstract 1.1 If the moral philosopher cannot help with the problems of medical ethics, he ought to shut up shop. The problems of medical ethics are so typical of the moral problems that moral philosophy is supposed to be able to help with, that a failure here really would be a sign either of the uselessness of the discipline or of the incompetence of the particular practitioner. I do not want to overstate this point, however. It could be the case that, so far as practical help goes, philosophy is at the stage now at which, not so long ago, medicine was. It has been said that until fairly recently one was more likely to survive one’s illnesses if one kept out of the hands of the doctor than if one allowed oneself to be treated—and this was at any rate true of the wounded on battlefields, because the surgeons’ instruments were not sterilized. Yet all the same medicine has now progressed to a stage at which it saves lives. The change came when certain methods got accepted: I mean, not merely such things as aseptic surgery, but also the application to medicine of the scientific method in general, which meant that firm and reliable procedures were adopted for determining whether a certain treatment worked or not; and also the relation of medicine to fundamental knowledge about physiology and biochemistry, which made possible the invention of new treatments to be tested in this way.

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"General considerations." In Paediatric Surgery, edited by Mark Davenport and Paolo De Coppi, 11–72. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198798699.003.0002.

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This chapter covers the general considerations in safely and effectively performing paediatric surgery. It starts with the ethical and legal requirements, including withdrawal of treatment, treating children in the Jehovah’s Witness faith, and safeguarding. It then outlines evidence-based medicine, including meta-analysis, statistics, and reporting trials. Transport of the sick child, anaesthesia, analgesia, intensive care, sepsis, and the use of antibiotics in children are all covered. Day-case surgery, from its history to indications, pre- and postoperative care, and proper documentation, is described. Pre-assessment, care of the neurologically impaired child, basics of vascular access and radiology, and nutrition in the surgical patient are all covered.

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Bloch, Sidney, and Stephen Green. "Psychiatric ethics." In New Oxford Textbook of Psychiatry, 28–32. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199696758.003.0006.

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A myriad of ethical problems pervade clinical practice and research in psychiatry. Yet with few exceptions, psychiatric ethics has generally been regarded as an addendum to mainstream bioethics. An assumption has been made that ‘tools’ developed to deal with issues like assisted reproduction or transplant surgery can be used essentially unmodified in psychiatry. These tools certainly help the psychiatrist but the hand-me-down approach has meant that salient features of psychiatric ethics have been prone to misunderstanding. Psychiatric ethics is concerned with the application of moral rules to situations and relationships specific to the field of mental health practice. We will focus on ethical aspects of diagnosis and treatment that challenge psychiatrists, and on codes of ethics. Resolution of ethical dilemmas requires deliberation grounded in a moral theoretical framework that serves clinical decision-making, and we conclude with our preferred theoretical perspective.

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Conference papers on the topic "General surgery – ethics"

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Mittal, Sujata. "Cervical cancer management in Rural India: Are we really living in 21st century or need to focus on health education of our doctors." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685408.

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Objectives: To study cases of cervical cancer managed/unmanaged in rural India and to analyze the reasons for poor outcome. Methods: This is a retrospective study of 218 cases of cervical cancers between 2008-2013 with resultant outcome in terms of treatment or absence of treatment in spite of diagnosis. Reasons for not taking the treatment have been analyzed. Also, analysis of 21 cases of simple hysterectomy with resultant complications like VVF, RVF has been done. Indications of surgery, operating surgeon, availability of preoperative/postoperative HPR, slides/blocks, discharge summary and disease status at the time of referral was done. Results: 44% refused to take treatment in spite of stage III diagnosis citing financial constraints, distance to be traveled daily for RT and apathetic attitude of family towards females. 20.65% opted for other hospitals. 29.8% took complete treatment. 80% of females were illiterate and dependent. 9.7% had simple hysterectomy for invasive disease. 95% of simple hysterectomies were performed by general surgeons in private setups resulting in 19% of complications like VVF, RVF. 100% cases of simple Hysterectomy did not have pre-operative biopsy. Only 50% cases had post-operative biopsy report and in none of the cases were slide/blocks available for review as trained pathologists were not available. General surgeons who had performed surgery were neither trained in doing P/V examinations nor aware of staging of cervical cancer. Conclusion: Illiteracy, poverty and absence of implementation of cancer control programs are the major hurdles in control of cervical cancer. The study highlights the absence of Government’s will to control cervical cancer in rural India. It emphasizes on the need of intensive training and health education of gynaecologists and surgeons at district/rural level, lack of which is a primary factor for violation of medical ethics by the doctors.

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Vieira, René Aloisio da Costa, Regis Resente Paulinellli, and Idam de Oliveira-Junior. "Extreme oncoplasty: Past, present, and future." In Brazilian Breast Cancer Symposium 2023. Mastology, 2023. http://dx.doi.org/10.29289/259453942023v33s1034.

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Objective: Recently, a new paradigm has been considered for mastectomy candidates with large multifocal and multicentric tumors, designated extreme oncoplasty (EO), which has evolved into new techniques for breast-conserving surgery (BCS) to be performed in tumors with limited conditions for BCS. At present, there are few publications, and there is no uniform description grouping all technical possibilities and new indications. The objective was to perform a systematic review about EO. Methodology: Based on resolution 466 from 12/12/12, it is not necessary to be evaluated by the Ethics Committee. A systematic review was conducted to evaluate the indications and surgeries performed in the context of EO. We used PICO for article evaluation: Problem = breast neoplasm; Intervention = OS, EO, or reconstructive surgical procedures; Comparison = all; and Outcome = indication and type of surgery. A literature review was performed by screening two databases (PubMed and LILACS). To evaluate articles in PubMed, we used the terms: (((“breast neoplasms”[Mesh]) AND (“surgery, plastic”[Mesh] OR “plastic surgery procedures”[Mesh] OR “mammaplasty”[Mesh] OR “mastectomy, segmental”[Mesh])) AND (“oncoplastic surgery” OR “oncoplasty” OR “oncoplastic” OR “extreme oncoplasty” OR “extreme oncoplastic” OR “regional flaps” OR “geometric compensation”)). The terms used in LILACS were “neoplasias da mama” and “procedimentos cirúrgicos reconstrutivos”; “neoplasias da mama” and “cirurgia oncoplastica ou oncoplastia.” Results: Initially, 787 articles were identified from the PubMed database. The titles and abstracts were evaluated, and 140 articles were selected for reading. After content evaluation (November 30, 2022), 39 articles were selected for this study. Specifically, for EO, 23 original articles and 4 comments were evaluated. Silvertein suggested the term EO and the articles selected here. Paulinelli considered the term GC using wise pattern resection, and similar articles were selected. We found articles related to preoperative care, traditional indications, increased indications, and casuistic and case reports. Quality of life was evaluated. In addition, four replies were published. We found two articles on LILACS, one of which was included. Classical indications were tumors larger than 5 cm and multifocal and multicentric tumors, which the initial surgery to be considered was mastectomy. New indications were (1) breast tumor unfavorable ratio; (2) extensive microcalcifications or extensive CDIS; (3) new or recurrence in irradiated breasts; (4) locally advanced breast carcinoma with partial response to chemotherapy; (5) inappropriate scare; and (6) medium and low breast with ptosis. New situations are small- to moderate-sized non-ptotic with centrally located breast cancer, small- to moderate-sized breast and flaps. We observed new options, including general discussions, partial breast amputation, regional flaps, and other techniques. Conclusion: EO represents a new paradigm related to BCS. It is important to discuss the technical possibilities, improving the number of patients to be selected for these surgeries.

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Chandna, A., Group PRIORITISE Study, R. Mahajan, P. Gautam, L. Mwandigha, K. Gunasekaran, D. Bhusan, et al. "Facilitating safe discharge through predicting disease progression in moderate COVID-19: development and validation of a prediction model in resource-limited settings." In MSF Scientific Days International 2022. NYC: MSF-USA, 2022. http://dx.doi.org/10.57740/hxy9-yk07.

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INTRODUCTION In locations where few people have received Covid-19 vaccines, health systems remain vulnerable to spikes in SARS-CoV-2 infections. Triage tools, which could include biomarkers, to identify patients with moderate Covid-19 infection suitable for community-based management would be useful in the event of surges. In consultation with FIND (Geneva, Switzerland) we shortlisted seven biomarkers for evaluation, all measurable using point-of-care tests, and either currently available or in late-stage development. METHODS We prospectively recruited unvaccinated adults with laboratory-confirmed Covid-19 presenting to two hospitals in India with moderate symptoms, in order to develop and validate a clinical prediction model to rule-out progression to supplemental oxygen requirement. Moderate disease was defined as oxygen saturation (SpO2) ≥ 94% and respiratory rate < 30 breaths per minute (bpm), in the context of systemic symptoms (breathlessness or fever and chest pain, abdominal pain, diarrhoea, or severe myalgia). All patients had clinical observations and blood collected at presentation, and were followed up for 14 days for the primary outcome, defined as any of the following: SpO2 < 94%; respiratory rate > 30 bpm; SpO2/fraction of inspired oxygen (FiO2) < 400; or death. We specified a priori that each model would contain three easily ascertained clinical parameters (age, sex, and SpO2) and one of the seven biomarkers (C-reactive protein (CRP), D-dimer, interleukin-6 (IL-6), neutrophil-to-lymphocyte ratio (NLR), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), or soluble urokinase plasminogen activator receptor (suPAR)), to ensure the models would be implementable in high patient-throughput, low-resource settings. We evaluated the models’ discrimination, calibration, and clinical utility in a held-out external temporal validation cohort. ETHICS Ethical approval was given by the ethics committees of AIIMS and CMC, India, the Oxford Tropical Research Ethics Committee, UK; and by the MSF Ethics Review Board. ClinicalTrials.gov number, NCT04441372. RESULTS 426 participants were recruited, of which 89 (21.0%) met the primary outcome. 257 participants comprised the development, and 166 the validation, cohorts. The three models containing NLR, suPAR, or IL-6 demonstrated promising discrimination (c-statistics: 0.72 to 0.74) and calibration (calibration slopes: 1.01 to 1.05) in the held-out validation cohort. Furthermore, they provided greater utility than a model containing the clinical parameters alone (c-statistic = 0.66; calibration slope = 0.68). The inclusion of either NLR or suPAR improved predictive performance such that the ratio of correctly to incorrectly discharged patients increased from 10:1 to 23:1 or 25:1 respectively. Including IL-6 resulted in a similar proportion (~21%) of correctly discharged patients as the clinical model, but without missing any patients requiring supplemental oxygen. CONCLUSION We present three clinical prediction models that could help clinicians identify patients with moderate Covid-19 suitable for community-based management. These models are readily implementable and, if validated, could be of particular relevance for resource-limited settings. CONFLICTS OF INTEREST None declared.

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Yoshimura, Adriana Akemi, André Mattar, Bruna S. Mota, Carlos Elias Fristachi, Eduardo Carvalho Pessoa, Felipe Eduardo Andrade, Giuliano Tosello, et al. "A MULTICENTRIC STUDY ON BREAST CANCER IN ULTRA YOUNG WOMEN: III – THERAPEUTIC ASPECTS AND ONCOLOGICAL OUTCOMES." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1091.

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Introduction: We have originally introduced the concept of ultra young women (UYW), defined as age ≤30 years old. It is generally accepted that UYW patients with breast cancer (BC) share some unfavorable outcomes and the patients are faced with family and professional problems, and unique quality of life issues, including loss of fertility, contraception, pregnancy, sexuality, cancer during pregnancy, body image and emotional distress, that complicate treatment decisions making. Objectives: Study the type of surgical and systemic treatment and oncologic outcomes in UYW with BC. Methods: We conducted a multicentric, observational, retrospective study of consecutive BC UYW patients. Only patients with infiltrating BC were included. Nine Mastology Centers located in the State of São Paulo participated. The following data were recorded: type of surgery, chemotherapy, endocrinetherapy, and radiotherapy. Individual oncologic evolution was analyzed and the patients were classified as alive without disease (AWD), alive with local recurrence (ALR), alive with systemic recurrence (ASR), died from BC (DBC) or died from another cause (DOC). The research protocol was approved by the Ethics Committee of all Collaborative Centers. Results: Sixteen percent of UYW with BC underwent mastectomies, 10% nipple-sparing mastectomies and 16% breast conservative surgeries. About 50% had immediated breast reconstruction. Sentinel node biopsy was performed in 24%. 18% had more than four compromised LNs, 8% with extracapsular leak. 37% received adjuvant or palliative chemotherapy. 61% were submitted to irradiation. 54% had adjuvant hormonetherapy. The mean time of follow-up was 41.5 months (1.5-207). It was observed that 59% were AWD, 1% ALR, 7% ASR and 23% DBC, unfortunately standing out the elevated contingent of BC-related deaths. Conclusions: BC therapy in UYW were tailored according to individual characteristics, but the oncological outcomes in this age range at the moment could be considered unfavorable.

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Lowe, G. D. O. "EPIDEMIOLOGY AND RISK PREDICTION OF VENOUS THROMBOEMBOLISM." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642965.

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Uses of epidemiology. Venous thromboembolism continues to be an important cause of death and disability in Western Countries. Its epidemiology may provide clues to etiology, e.g. the increased incidence in oral contraceptive users, and the low prevalence at autopsy in Central Africa or Japan compared to the U.S.A. A second use is the monitoring of time-trends: the diagnosis of pulmonary embolism increased during the 1970s, although the case fatality decreased. A third use is the identification and quantification of risk factors: these could be modified in the hope of prevention, or else used to select high risk groups for selective prophylaxis, e.g. during acute illness. Prevention is the only feasible approach to reducing the burden of venous thromboembolism, since most cases are not diagnosed, and since the value of current treatment is debatable.Case definition. Presents problems: clinical diagnosis is unreliable, and should if possible be supported by objective methods. Autopsy studies are performed on selected populations, at a decreasing rate; the frequency of thromboembolism depends on technique; and pathologists cannot be blinded and are open to bias. It can also be difficult to judge whether a patient dying with pulmonary embolism died from pulmonary embolism. 125I-fibrinogen scans indicate minimal disease, and now present ethical problems in screening due to risks of viral transmission. Venography is invasive and is not readily repeatable, which limits its use as a screening method. Plethysmography merits wider evaluation, since it is non-invasive, and sensitive to major thrombosis.Community epidemiology. Data on the community epidemiology are limited. The risk increases with age. When age is taken into account, there is little sex difference. Overweight in women, use of oral contraceptives and blood group A increase the risk: smoking, varicose veins, blood pressure, cholesterol and glucose do not, on current evidence. Long-term follow-up of patients with proven thromboembolism shows an increased risk of malignancy, hence occult cancer may also be a risk factor. Polycythaemia and certain congenital deficiencies (e.g. antithrombin III) are also well-recognised risk factors, although uncommon.Hospital epidemiology. Data on hospital epidemiology are derived largely from autopsy prevalence, and from short-term incidence of minimal thrombosis detected by 125I—fibrinogen scanning. Old, immobile and traumatised patients are most at risk. Previous thromboembolism, polycythaemia, antithrombin III deficiency, hip and leg fractures, elective hip and leg surgery, hemiplegia, paraplegia, and heart failure carry high risks, and merit consideration for routine prophylaxis. The risk in elective surgery precedes the operation, and increases with age, overweight, malignancy, varicose veins, non-smoking, and operative factors (duration, approach, general anaesthesia, intravenous fluids). Diabetics appear to have no extra risk. Combinations of clinical variables can be used to predict high risk groups for selective prophylaxis, but combination indices require further study. Laboratory variables may increase the predictability of deep vein thrombosis, but the results of published studies are conflicting, and the cost-effectiveness of laboratory prediction should be evaluated.

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André, Ayla Nóbrega, João Victor Bezerra Ramos, and Lakymê ângelo Mangueira Porto. "QUALITY OF LIFE OF YOUNG WOMEN WITH BREAST CANCER IN A REFERENCE HOSPITAL IN PARAÍBA." In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1068.

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Introduction: Breast cancer is the main cancer in women in Brazil and worldwide, it and is the leading cause of death among women in Brazil. Although it is more common in women over 40 years, when it occurs in younger women, it generally has a worse prognosis, thus leading to more aggressive treatments and generating more long-term sequelae. Objective: The aim of this research was to analyze the quality of life of women breast cancer survivors under 40 years of age. Methods: This is an observational, cross-sectional study that was carried out at the Hospital Napoleão Laureano, which is the reference for the treatment of breast cancer in Paraíba. The project was submitted to the Research Ethics Committee of the Centro de Ciências Médicas of the Universidade Federal da Paraíba, and the patients signed an informed consent form. Data collection was performed between September 2020 and February 2021. We had to conduct most of the interviews by telephone, because the COVID-19 pandemic decreased the flow of patients to the outpatient clinic. Results: In this time period, we identified 76 patients who fit the inclusion criteria for the survey, and from these, we obtained 47 responses to the quality of life questionnaire. Among those who answered the survey, only four had not yet had any surgical procedure on their breasts. Of the 43 women who had undergone surgery, most still suffer from pain (27.6%) or discomfort (63.8%) in the area of the breasts and upper limbs, and 63.8% also feel a decrease in the strength of this homolateral upper limb. This is very important data, because pain is responsible for a great decrease in quality of life, so much so that chronic pain can lead to symptoms of depression in breast cancer survivors. In the second part of the questionnaire, we asked about body image, since the breast region is generally a very important area of women’s bodies. More than 70% of the interviewees feel beautiful and satisfied with their sex life; often related to the support they are receiving, be it from family, friends, health professionals, or even from social media. Even so, they have noticed a drop in libido, which is a common side effect of chemotherapy, a topic not usually addressed in medical consultations. They were asked about their desire to have children, since many cancer treatments can lead to premature ovarian failure, early menopause, and infertility; 36% of them said that the diagnosis changed their desire to get pregnant, demonstrating that the issue of fertility is not being properly addressed among these women, since fertility preservation options are not even available in the Brazilian public health service. Another issue addressed was the socioeconomic issues related to the diagnosis and treatment of the disease, considering that in Brazil, women are responsible for the family income in more than half of the households. Although cancer treatment in Brazil is free of charge, 68% of the women had to stop work or take a medical leave, and about 78% of them said that their financial conditions worsened during the treatment, increasing their worries in this already extremely stressful period. Conclusion: The evolution of therapies in the treatment of breast cancer has allowed a considerable survival rate for this disease. Thus, the management of the sequelae of the disease and treatment, and the quality of life of these women survivors, also becomes the responsibility of the health team, so that studies on this are fundamental to provide better assistance.

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Reports on the topic "General surgery – ethics"

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Willatt, Carlos, Carlos Ossa, Rodrigo Fuentealba, and Fernando Murillo,. La simulación pedagógica como aproximación temprana al Ethos profesional docente. Universidad Autónoma de Chile, April 2024. http://dx.doi.org/10.32457/12728/11186202485.

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En este documento presentamos el modelo de simulación pedagógica desarrollado en la Facultad de Educación de la Universidad Autónoma de Chile (UA), entendiendo la simulación pedagógica como una estrategia para el ensayo, apropiación y modelamiento de acciones docentes básicas. Expondremos aspectos generales del modelo, enfocados en el ciclo inicial de la formación docente en la facultad, señalando también algunos desafíos que surgen en su implementación.

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