Articles: surgery.
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All trainees in general surgery holding a national training number in six regions (Mersey, North West, Trent, Yorkshire, Northern, West Midlands) were identified, and those accredited or within 3 years of their CCST (n = 136) were telephoned to ascertain their primary subspecialist interest, whether they had a higher degree and what their desired consultant job would be. The consultant vacancies advertised in the British Medical Journal between 3 January 1998 and 8 May 1999 were assessed according to the required subspecialist interest. ⋯ Upper gastrointestinal surgery appears to be the most competitive of the general surgical subspecialties at present, having by far the lowest ratio of jobs to trainees. In addition, 87 per cent of upper gastrointestinal trainees have or are completing a higher degree, and 43 per cent expressed a desire to work in a teaching hospital.
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Spinal cord stimulation (SCS) is an efficient means for treatment of the postsurgical lumbar spine condition known as failed back surgery syndrome (FBSS). Although the devices and the implantation techniques are well established and the technology is sophisticated, there are some complications caused by hardware failures. This study was aimed at identifying the most frequent types of hardware failures and their causes in FBSS patients treated with SCS. ⋯ Second in frequency were receiver (model 3470) failures due to insulation leakage at the plug connection site (n= 2). In one case, extension cable breakage caused dysfunction of the system, and another dysfunction was caused by distal extension cable disconnection. In conclusion, SCS is a low-complication procedure for treatment of benign low-back pain, but seems to be prone to lead and insulation failures.
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Journal of anesthesia · Jan 2000
Continuous intra-arterial blood gas monitoring during thoracic surgery.
This study was undertaken to assess the clinical usefulness of a continuous intra-arterial blood gas (CIABG) monitoring system, Paratrend 7, during thoracic surgery. ⋯ The agreement between CIABG and ABG measurements was better for PCO(2) and pH than for PO(2). The PO(2) value displayed on the CIABG monitor may not always be reliable during thoracic surgical procedures.
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Journal of anesthesia · Jan 2000
Effects of sevoflurane and isoflurane on the ratio of cerebral blood flow/metabolic rate for oxygen in neurosurgery.
To examine the changes in cerebral blood flow (CBF) equivalent (CBF divided by cerebral metabolic rate for oxygen) during craniotomy under isoflurane and sevoflurane anesthesia in patients with intracranial disorders. ⋯ Deepening anesthesia from 0.5 to 1.0 MAC was maintained with no difference between the two agents during 4h of neurosurgery.