Canadian journal of surgery. Journal canadien de chirurgie
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Comparative Study
Lower extremity burns and Unna paste: can we decrease health care costs without compromising patient care?
To compare an alternative treatment for lower extremity burns with the standard in-hospital treatment, in an attempt to shorten hospital stay. ⋯ This alternative treatment is safe, inexpensive and effective and is recommended as the treatment of choice for uncomplicated, noncircumferential lower extremity burns.
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Anterior tarsal tunnel syndrome is a rare condition in which the deep peroneal nerve is trapped below the extensor retinaculum at the ankle. The authors report a variation of this condition: a 67-year-old woman who had anterior tarsal tunnel syndrome caused by entrapment of the deep peroneal nerve by the extensor hallucis brevis muscle. Conservative treatment was unsuccessful, but surgical decompression of the nerve provided immediate improvement, and by 2 weeks postoperatively she had no residual pain or paresthesia, although there was some numbness in the first web space.
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Comparative Study
Comparison of initial laparoscopic cholecystectomy at a community hospital versus a teaching hospital.
To compare the initiation of laparoscopic cholecystectomy at a community hospital versus a tertiary-care teaching hospital. ⋯ The introduction of laparoscopic cholecystectomy during a 2-year period was achieved safely at both hospitals. The complication rates were similar. The length of stay and operating times were shorter in the community hospital.
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Case Reports
Tarsal tunnel syndrome: an unusual case resulting from an intraneural degenerative cyst.
Multiple local and systemic entities have been implicated as causes of tarsal tunnel syndrome. In this report, a 31-year-old man presented with medial plantar nerve compression caused by an intraneural degenerative cyst of the posterior tibial nerve. Removal of the cyst and decompression of the nerve relieved his symptoms. This is the first time that such an entity has been reported as a cause of tarsal tunnel syndrome.
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Societal, technologic, organizational and educational developments during the past 10 years have brought about increasing promises for change in the graduate medical education of cardiac and thoracic surgeons. These changes effectively lengthened training to 8'years and created a double standard for the education of a thoracic surgeon. A task force mandated by the Royal College of Physicians and Surgeons of Canada nucleus committees in both cardiac and thoracic surgery and with the support of the Canadian Society of Cardiovascular and Thoracic Surgeons studied the problem and made the following recommendation: cardiac surgery and thoracic surgery should each become a primary specialty with its own nucleus committee. ⋯ Each specialty could also be entered after completion of full training in general surgery. The task force also urged the development of a curriculum to guide educational objectives in each specialty. These changes will produce a flexible, shorter, more focused program for cardiac and thoracic surgeons for both university and community settings.