Welcome to my blog on surgery and related sciences. Here I will express views on the art and science of surgery in general. Any comments and thoughts are most welcomed.
Showing posts with label international. Show all posts
Showing posts with label international. Show all posts

Saturday, 21 December 2013

Freebies from the BJS: Emergency surgery issue launched hot from the press!!!

Now it is available for access and free download: The themed Emergency surgery issue is now published on the BJS website and can be searched up in Pubmed.

Go to this link to access the content!

Have a Merry Xmas everyone!!!



Volume 101 Issue 1 (January 2014)

Leading articles

Improving outcomes in emergency surgery 

  • Author:A. Bergenfelz, K. Søreide
  • Published: Nov 27, 2013
  • Pages: e1-e2

Barriers, regulations and solutions in emergency surgery research 

  • Author:T. J. Coats
  • Published: Nov 25, 2013
  • Pages: e3-e4

Checklists and crisis management in surgical emergencies 

  • Author:K. Ram, M. A. Boermeester
  • Published: Nov 13, 2013
  • Pages: e5-e6

Organization of emergency surgery 

  • Author:A. Leppäniemi
  • Published: Nov 13, 2013
  • Pages: e7-e8

Reviews

Global disease burden of conditions requiring emergency surgery 

  • Author:B. Stewart, P. Khanduri, C. McCord, M. Ohene‐Yeboah, S. Uranues, F. Vega Rivera, C. Mock
  • Published: Nov 25, 2013
  • Pages: e9-e22

Commentary

Global disease burden of conditions requiring emergency surgery ( Br J Surg 2014; 101: e9–e22) 

  • Author:R. T. Petroze
  • Published: Dec 12, 2013
  • Pages: e23-e23

Reviews

Contemporary management of abdominal surgical emergencies in infants and children 

  • Author:L. W. E. van Heurn, M. P. Pakarinen, T. Wester
  • Published: Nov 29, 2013
  • Pages: e24-e33

Multidisciplinary management strategies for acute non‐variceal upper gastrointestinal bleeding 

  • Author:Y. Lu, R. Loffroy, J. Y. W. Lau, A. Barkun
  • Published: Nov 26, 2013
  • Pages: e34-e50

Strategies to improve the outcome of emergency surgery for perforated peptic ulcer 

  • Author:K. Søreide, K. Thorsen, J. A. Søreide
  • Published: Nov 29, 2013
  • Pages: e51-e64

Staged multidisciplinary step‐up management for necrotizing pancreatitis 

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Friday, 8 November 2013

Centenary Talks given at ASGBI, Glasgow and ACS, Washington 2013

Related to the BJS centenary a symposium was held at the International Surgical Congress of the Associations of Surgeons of Great Britain & Ireland in Glasgow, May 2013. You can find all the lectures to the ASGBI 2013 BJS Symposium: 100 years of BJS by going to the BJS website.
Also, a co-anniversary was held in Washington DC, marking the 100 years of both the BJS and the American College of Surgeons. The symposium can be view in entirety here.
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Saturday, 26 October 2013

International collaboration in surgical research: Lancet paper

The Lancet
I very recently had the privilege to be leading a group of authors under the acronym IRIS working group (Int'l Research collaboration In Surgery) to produce a report on the current state of research collaboration across borders in surgery and suggestions as to how this can be improved for the future.
Considering the huge number of surgeries performed worldwide each year - it is estimated at 245 million operations, and not taking into account that a large part of surgeons' work consists also of non-operative management of surgical disease - the number of patients that are accrued or contributing to trials is a mere minimum, likely far below 1% of all surgeries performed.

In the paper it is being discussed the different types of strategies that can be explored to increase collaboration and involvement in research for surgeons. Obviously this is but a starting point and there is a lot more to be said and even more to be done to rectify the current state of surgical trial activity.

You can read the full paper at the Lancet or search the reference at the bottom page here.

Please do get in contact should you have any ideas or would like to get involved from your part in this.
You can send me any note (or request for the full paper) through this link.

The Lancet, Volume 382, Issue 9898, Pages 1140 - 1151, 28 September 2013, doi:10.1016/S0140-6736(13)61455-5.

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Saturday, 8 December 2012

Acute pancreatitis reclassified - twice!

Acute pancreatitis is a fairly common disease mot often caused by either gallstone disease or alcohol, with a number of other causes involved as well. The natural history may be unpredictable - mild disease usually resolves without any or just little medical support, while severe disease may involve into several complications, need for organ support and intensive care, and have a mortality as high as 30%.
Predicting which patient will develop severe disease is difficult, with a number of scoring systems proposed over the years; the Ranson score, Imrie (or Glasgow) score, the Harmless Acute Pancreatitis Score (HAPS), the APACAHE II score, JSS, BISAP, SIRS, Panc, POP, and so on...
However, noen of these work perfectly - the clinical prediction riles have reached their limitation (see Mounzer, Gastroenterology, 2012).

Disease severeity and classification of acute pancreatitis have been based on the Atlanta consensus from 1992. Several components of this classification have been controversial and critized over the years, and several research groups have argued for better definitions in order to compare results between studies and generate commonly agreed definitions for conducting trials.

This work has over the past several years come to fruition through two released international consensus reports:

One from the "Acute Pancreatitis Classification Working Group"

 Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2012 Oct 25. [Epub ahead of print]


and the other one from the PANCREA group


Dellinger EP, Forsmark CE, Layer P, Lévy P, Maraví-Poma E, Petrov MS,Shimosegawa T, Siriwardena AK, Uomo G, Whitcomb DC, Windsor JA; Pancreatitis Across Nations Clinical Research and Education Alliance (PANCREA). Determinant-Based Classification of Acute Pancreatitis Severity: An International Multidisciplinary Consultation. Ann Surg. 2012 Dec;256(6):875-880.



The consensus reports will hopefully allow for commonly agreed terms and definitions for future research. A problem is obviously that the two reports divert somewhat in their agreement in the number of categories neede for classifying acute pancreatitis. In the Gut paper the authors have defined a 3-tier system og mild, moderate and severe pancreatitis. The Annals paper have added a fourth group, named crititcal acute pancreatitis, when organ failure persists WITH the addition of infected (peri)pancreatic necrosis.

The Gut paper has emphasized several agreed terms and definitions for radiological classification of early (<4 weeks) and late (>4 weeks) fluid collections (such as "acute peripancreatic fluid collection; APFC" and "walled off necrosis; WON") to be distinguished from other terms such as "pseudocysts" and the now abandonded term "pancreatic abcess".

Which of the two suggestions will prevail over the other remains to be seen.
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