ANZ journal of surgery
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ANZ journal of surgery · Oct 2011
Multicenter Study Comparative StudyPerioperative risk analysis for acute respiratory distress syndrome after elective oesophagectomy.
Acute respiratory distress syndrome (ARDS) is a major contributor to respiratory morbidity and mortality after oesophagectomy. Several pre-, intra- and post-operative factors are thought to predispose to its development in the post-oesophagectomy period. The aim of this study was to determine factors predisposing to ARDS in the post-oesophagectomy period. ⋯ Preoperative physiological status as indicated by a preoperative history of chronic respiratory disease and preoperative pulmonary function influenced the post-operative outcome in our patients. The use of perioperative inotropes suggests perioperative cardiorespiratory instability, and could also predispose to the development of ARDS in the post-operative period.
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ANZ journal of surgery · Oct 2011
Comparative StudyProfile, transport and outcomes of severe burns patients within an inclusive, regionalized trauma system.
Severe burns represent a challenging and complex clinical presentation, requiring highly specialized burns centres that are staffed and equipped appropriately. The integration of burns care into trauma systems has been recommended. This study describes the profile, transfer and outcomes of severe burns within an inclusive, regionalized trauma system. ⋯ An inclusive trauma system with burns services co-located at the major trauma services resulted in almost complete referral of severe burns cases to burns services for management. Half of the cases arrived at the burns services directly from the scene of injury, highlighting the importance of ongoing clinical education about the initial management of severe burns at non-burns service hospitals.
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ANZ journal of surgery · Oct 2011
Comparative StudyPracticalities of developing a breast magnetic resonance imaging screening service for women at high risk for breast cancer.
Demand for screening breast magnetic resonance imaging (MRI) for women with a hereditary predisposition to breast cancer has increased since the introduction of a medicare item number. To aid future service planning, we examined the practicalities of establishing and running a breast MRI screening programme for high risk women and to describe the early outcomes of our screening programme. ⋯ Significant time, staff and equipment is required to run an effective breast MRI screening programme and this must be considered by future service providers.
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Common peroneal neuropathy occurs as a result of compression of the common peroneal nerve (CPN) in the fibro-osseous tunnel between the fibular neck and the tendinous arch of peroneus longus. High rates of spontaneous recovery have been reported. However, there is a subset of patients who require decompression of the CPN at the fibular neck. ⋯ Patients with foot drop fared significantly better if their duration of symptoms prior to surgery was less than 12 months.