ANZ journal of surgery
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The surgical workforce is ageing. This will impact on future workforce supply and planning, as well as the professional performance and welfare of surgeons themselves. This paper is a 'call to arms' to surgeons to consider the complex problem of advancing years and surgical performance. ⋯ This may be best facilitated by some form of informed and guided self-monitoring or 'self-screening'. It should be emphasized that self-screening is not a form of self-treatment but aims to enhance insight, using a tool kit of resources to promote adaptive ageing. Moreover, self-screening should not be restricted to cognition, which is only part of the picture of ageing, but extended to emphasize the maintenance of mental and physical wellness, and the acceptance of independent professional treatment and support when required.
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ANZ journal of surgery · May 2014
Predictive value of C-reactive protein with Alvarado score in acute appendicitis.
The aim of the study was to evaluate whether C-reactive protein (CRP) level on admission could aid the diagnostic accuracy of Alvarado score in acute appendicitis. ⋯ The Alvarado score and CRP taken together improve the predictive value of diagnosing acute appendicitis. Having a normal CRP in the equivocal group of Alvarado 4-6, should be further evaluated by advanced imaging before proceeding to appendicectomy.
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ANZ journal of surgery · Apr 2014
ReviewThe osteochondral dilemma: review of current management and future trends.
The management of articular cartilage defects remains challenging and controversial. Hyaline cartilage has limited capacity for self-repair and post-injury cartilage is predominantly replaced by fibrocartilage through healing from the subchondral bone. Fibrocartilage lacks the key properties that characterize hyaline cartilage such as capacity for compression, hydrodynamic permeability and smoothness of the articular surface. ⋯ In this review, the currently accepted surgical approaches are reviewed and considered; debridement, marrow stimulation, whole tissue transplantation and cellular repair. More recent products, which employ tissue engineering approaches to enhance the traditional methods of repair, are discussed. Future trends must not only focus on recreating the composition of articular cartilage, but more importantly recapitulate the nano-structure of articular cartilage to improve the functional strength and integration of repair tissue.
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ANZ journal of surgery · Apr 2014
Review Comparative StudyAutologous fat transfer for breast augmentation: a systematic review.
The role of autologous fat transfer (AFT) for cosmetic breast augmentation is uncertain due to ongoing concerns regarding its safety and efficacy compared with other breast augmentation techniques. ⋯ Based on the limited evidence available, AFT was considered to be at least as safe as the nominated comparator procedures in regard to complications; however, its safety in regard to cancer detection could not be determined. The efficacy of AFT could not be determined.