Chris Christie Lap Band Surgery
We are following with interest the news reports today of the Chris Christie lap band surgery. Although we are not participating in his care, some general information on what lap band or laparoscopic gastric banding and typical clinical issues to be considered is detailed below.
Lap band surgery is a commonly performed surgical operation done for the control of morbid obesity. It is best performed by experienced bariatric surgeons and is sometimes referred to as the “mini” weight loss surgery.
However, while the surgery is not as extensive as the roux-en-Y reconfiguring of the gi tract, it is a operation that i...
Source: Inside Surgery - May 7, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire Chris Christie gastric surgery lap band surgery weight loss surgery Source Type: blogs
Gonorrhea Superbug Said To Be More Dangerous Than AIDS
Health officials around the world are becoming increasingly concerned about the emergent of a strain of gonorrhea that is resistant to all antibiotics. Physicians are concerned that contracting the infection could result in a gram negative sepsis and mortality within 24 hours.
To date, the superbug gonorrhea has been found in Japanese sex workers, California, and Norway.
The post Gonorrhea Superbug Said To Be More Dangerous Than AIDS appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - May 2, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire gonorrhea resistant superbug Source Type: blogs
Civil War Amputation Surgery Mortality Rates
Civil War amputation surgery was distressingly common and carried a high mortality rate. Contrary to common thinking, almost all amputation surgery was carried out under ether or chloroform anesthesia and morphine was readily available for post-operative care.
The main problem in amputation that caused a high mortality was wound infection. The following is the mortality rate suffered by Union soldiers with the described level of amputation
toes – 6%
below the knee – 33%
at the knee – 58%
thigh – 54%
hip joint – 83%
fingers – 3%
forearm – 14%
upper arm – 24 %
The post Civil Wa...
Source: Inside Surgery - April 29, 2013 Category: Surgeons Authors: Editor Tags: History of Surgery and Medicine Trauma Surgery Source Type: blogs
John Brickman Wall, MD, Charged in Murder of Ex-Wife
John Brickman Wall, MD, a pediatrician in Utah, has been arrested in the murder of his ex-wife Uta Von Schwedler.
The post John Brickman Wall, MD, Charged in Murder of Ex-Wife appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - April 26, 2013 Category: Surgeons Authors: Editor Tags: Medical News Wire John Brickman Wall murder pediatrician Uta von Schwdler wife Source Type: blogs
Tourniquet – How to Make One in An Emergency
Like many Americans, we have followed the events in Boston bombing over the last week closely. While many aspects of the bombing were horrible, one uplifting aspect was the brave and heroic response of untrained bystanders who rushed to aid the injured, many of whom received complex lower extremity wounds.
An interview today done by Anderson Cooper with Adrianne Haslet-Davis and her husband revealed that after they were injured they attempted to tourniquet their wounds with leather belts that they looped through the buckle and then pulled up tight. They should be commended for keeping cool enough in a terrifying situation...
Source: Inside Surgery - April 24, 2013 Category: Surgeons Authors: Editor Tags: Trauma Surgery Adrianne Haslet-Davis boston bombing emergency field how to make how to use tourniquet Source Type: blogs
Boston Bombing Suspect – Is He Competent for Legal Proceeding in ICU?
In the continuing case of the Boston bombing suspect Tsarnaev, news organizations today report that a legal proceeding was held in his ICU room with a magistrate, federal prosecutors, and defense attorneys. The patient was read his rights by the magistrate in Beth Israel Deaconess Hospital and was given the charges against him.
While we are not attorneys, it is important and interesting to note that if the proceeding planned was an upcoming medical one and not a legal one, the patient would almost certainly not meet the requirements for competency, consent, and capacity to make a decision that would allow the procedure to...
Source: Inside Surgery - April 22, 2013 Category: Surgeons Authors: Editor Tags: Musings boston bomb suspect capacity competent ICU magistrate miranda read rights read ro Source Type: blogs
Boston Bombing Suspect Sedated and Communicating
We continue to follow the reports of the medical care being given by Boston bombing suspect Dzhokhar Tsaranaev. The patient is reportedly intubated and sedated but able to communicate with investigators via writing.
CNN has a report that discusses this written in part by health reporter Elizabeth Cohen that uses quotes from several physicians commenting on the case. Unfortunately, these characterizations are inaccurate and wrong and were given by two physicians (Dr. Albert Wu and Dr. Corey Siegel) that obviously do not routinely sedate patients trauma patients in an ICU.
Only Dr. Athos Rassias of Dartmouth, who is Directo...
Source: Inside Surgery - April 22, 2013 Category: Surgeons Authors: Editor Tags: Musings Albert Wu bomb breathing communicating Corey Siegel ICU propofol Ramsey sedation suspect Tsarnaev Source Type: blogs
Boston Bomber Possible Suicide Attempt
The news reports of the wounds suffered by the Boston bomber suspect being treated at Beth Israel Deaconess Medical Center grow more interesting by the hour.
ABC News is now reporting that the suspect has a wound in the back of the neck, which is leading investigators to conjecture that the wound may be the result of an self-inflicted wound in an unsuccessful suicide attempt. One scenario being discussed is that the suspect may have placed the end of the gun barrel in his mouth and pulled the trigger but failed to kill himself.
From a purely clinical point of view and assuming the suspect did not flinch and give himself a...
Source: Inside Surgery - April 21, 2013 Category: Surgeons Authors: Editor Tags: Musings bomber boston next wound suicide suscept Source Type: blogs
Boston Bomber Intubated and Sedated
We are following news reports that the alleged Boston bomber Dzhokar Tsarnaev is currently intubated (breathing tube placed) and sedated, as we surmised earlier would be the case, with injuries to the “throat.”
This is a medically imprecise description that would not be used by a trauma surgeon and in civilian parlance can mean one of several things. Likely it is an indication that he was injured by a gunshot wound to his trachea or esophagus. These are wounds that are not as immediately life-threatening as a gunshot wound to the carotid artery but can cause a longer and more difficult recovery.
A gunshot woun...
Source: Inside Surgery - April 21, 2013 Category: Surgeons Authors: Editor Tags: Critical Care Musings Trauma Surgery Beth Israel Deaconess bomb suspect boston Dzhokar injuries intubated sedated Tsarnaev wounds Source Type: blogs
Bombing Suspect’s Wounds
Bomb suspect’s wounds as possible clinical scenarios are discussed below:
Although we are not directly involved in the care of the alleged bombing suspect of the Boston Marathon Dzhokar Tsarnaev who was recently apprehended, we are closely following media reports of his arrest and subsequent transfer to the Beth Israel Deaconess Medical Center.
News reports have shown photos of him lying on the grass with his hands apparently cuffed and his shirt pulled up with law enforcement officers working over him. Also photos have been published of him climbing out of the boat under his own power and also of him on a stretcher...
Source: Inside Surgery - April 20, 2013 Category: Surgeons Authors: Editor Tags: Musings bombing Boston marathon Dzhokar Tsarnaev suspect wounds Source Type: blogs
Diabetes Insipidus
Diabetes insipidus is an endocrine disease marked by:
Pathophysiology of diabetes insipidus
1) clinical state marked by excessive production of dilute urine
2) caused by decreased secretion or activity of arginine vasopression
3) occurs in primary, secondary (or primary polydipsia), nephrogenic, gestational, and congenital forms
The post Diabetes Insipidus appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - April 20, 2013 Category: Surgeons Authors: Editor Tags: Endocrinology Source Type: blogs
Boston Marathon Terrorist Attack and Injuries
Like all Americans, we were horrified to hear of the terrorist act today at the finish line of the Boston Marathon. While reports are still coming in, there were at least two people killed and numerous people injured, some critically. This event hits home for us at InsideSurgery.com in several ways.
First, this writer, who is a trauma surgeon, attended the Boston Marathon last year as a spectator and managed to wangle a spot right at the finish line where the first bomb went off. Last year on Patriot’s Day as I made my way across the Boston common and toward the corner of Boylston and Ring Avenue I was amazed and a ...
Source: Inside Surgery - April 15, 2013 Category: Surgeons Authors: Editor Tags: Musings amputation attack Boston marathon Brigham complex injuries MGH physicians soft tissue terrorist Source Type: blogs
Posterior MI
is characterized by the following:
ECG
reciprocal changes in V2-V3
Coronary involvement
1. RCA
2. circumflex
Associated Clinical Conditions
bradycardia and heart block
The post Posterior MI appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - April 10, 2013 Category: Surgeons Authors: Editor Tags: Cardiology Source Type: blogs
Lateral Wall MI
Lateral wall MI characteristics are as listed below:
ECG changes
seen in V5, V6, I and AVL
Coronary involved
1. circumflex
2. diagonal branch of left anterior descending
Clinical complications
1. elevated central venous pressure
2. decreased cardiac output
3. AV block
The post Lateral Wall MI appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)
Source: Inside Surgery - April 10, 2013 Category: Surgeons Authors: Editor Tags: Cardiology Source Type: blogs
Anterior Wall MI
Anterior wall MI is a distressingly common occurrence in patients. Important clinical considerations are:
ECG
1. Anterior septal MI – V1-V3
2. Anterior MI – V1-V4
3. Lateral Anterior MI – V4-V6
Coronary involvement
left anterior descending
Cardiac areas involved
1. anterior wall of left ventricle
2. anterior 2/3 of septum
3. bundle of His
4. anterior superior division of left bundle branch
5. right bundle branch
6. posterior inferior division of left bundle branch
Clinical complications
1. bundle branch blocks
2. advanced heart blocks including Mobitz II and complete heart block
3. congestive heart failur...
Source: Inside Surgery - April 10, 2013 Category: Surgeons Authors: Editor Tags: Cardiology Source Type: blogs
