The Australian and New Zealand journal of surgery
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A plea is made for the early recognition of the possible development of painful conditions affecting peripheral nerves, since it is believed that the experience of our institution, which is detailed here, confirms that while rehabilitation programmes are of benefit to the patient, successful therapy depends upon prompt institution of prophylactic measures to prevent sensitization to sympathetic outflow. Patients are encouraged to use their hands, and it is considered important that they would understand that their complaints arise from a genuine organic condition.
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Cysticercus cellulosae, the larva of the pork tapeworm, has a predilection to encyst within the central nervous system. It is common in endemic areas, such as Central and South America, but rare in Australia. The clinical and radiological findings in two patients with fourth ventricular cysts are described.
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Pathological features such as tumour type, tumour size and lymph node invasion have an important bearing on the prognosis of the patient with breast cancer. It is suggested that such prognostic factors should be considered in the selection of women for post-mastectomy breast reconstruction. The implications of pathological and other factors are reviewed and a summary of favourable prognostic factors is presented.
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A simple safe technique of providing rapid, effective analgesia in children with femoral shaft fractures is described. It is particularly useful in patients who have associated head or abdominal injuries in the presence of which opiates should be withheld. The technique is recommended to all practitioners involved in the early care of femoral shaft fractures.
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Injuries of the nervous system are common, and cause many deaths and much permanent disability. They inflict an enormous financial burden on the national economy; in Australia, adequate data are at present lacking, but a simple extrapolation from Canadian statistic suggests an estimate of more than $500,000,000 annually for the injuries resulting from road traffic accidents alone; if other causes of injury are included, the figure may reach one billion dollars. The neurosurgeon is specifically trained to undertake the management of all forms of neurological trauma; however, in Australia, and in many other countries, only a small minority of such injuries receive neurosurgical care. ⋯ Many cases must therefore be in the care of general or orthopaedic surgeons, especially in country centres, and it is important that these surgeons should have some basic neurosurgical training. The Neurosurgical Society of Australasia wishes to formulate a programme to ensure that opportunities for such training are available throughout Australia. This programme should also embody a national plan for research into the treatment and prevention of neurological trauma.