Surgery Clinical Features Archive
Pediatrics patients with asthma who have to undergo surgery are at risk for complications.
The patient, aged 69 years, had a 43-year history of type 1 diabetes and was scheduled to undergo a chest wall resection.
A patient, aged 60 years, was admitted to the hospital to undergo renal transplant therapy. He had a history of type 2 diabetes for 15 years.
Consider using topical ethyl chloride before the use of anesthesia when working with infected skin.
When creating outpatient diabetes management plan, the patient's inpatient medication regimen should be considered but not necessarily replicated.
A patient, aged 57 years, was admitted to the hospital to undergo gastric bypass surgery. He had a history of type 2 diabetes for ten years.
More than 80,000 children undergo appendectomies each year.
Arthroscopic partial meniscectomy does not improve degenerative medial meniscus tear symptoms in patients without knee osteoarthritis.
No difference in hypotension between low-, high-dose steroids for IBD patients undergoing major colorectal surgery.
Intracranial bleeding and pressure after removal of an acoustic neuroma leads to permanent damage.
Enlisting a parent's help can provide comfort without a scary needle or painful injection.
Learn what factors distort the waves used in scanning procedures when metal is present.
Which drugs need to be stopped before surgery and how far in advance?
A young patient sustains a serious injury while playing with his brother.
A geriatric patient undergoes a complex procedure for gastric outlet obstruction and causes a medical team to question their stance on geriatric surgery.
A reluctant, asymptomatic patient visits an ophthalmology clinic for a 'minor' injury at his wife's prompting.
A nurse anesthetist acts quickly when a child begins coughing up copious amounts of blood after a routine procedure.
A patient with a gunshot wound to the head presents complaining of a fierce headache with a pillow hanging from his head.
A nurse misses a doctor's written order not to remove a patient's hand restraints.
Physical therapy associated with functional improvements similar to surgery for patients with meniscal tear and knee osteoarthritis.
Extended anticoagulation with apixaban or dabigatran reduces recurrent VTE and mortality without increasing major bleeding.
A woman is rushed to the emergency department after severing her hand in a woodworking accident at home.
Hydromorphone for postoperative pain does not appear to increase delirium in elderly patients having hip fracture surgery.
Steps to follow after wound irrigation to ensure patient comfort.
Could vitamin D and calcium supplements be causing foul smelling urine?
A lack of communication between a surgeon and an anesthetist has disastrous consequences.
Metastatic calcification of the left breast in a patient with renal failure raises suspicion.
What are the current evidence-based recommendations for aspirin and clopidogrel (Plavix) use following coronary artery bypass graft (CABG) surgery (both on- and off-pump procedures)?
What are the most effective therapies available to treat lymphedema?
Current recommendations from the American Heart Association and the American Stroke Association classify percutaneous transluminal angioplasty with stenting (PTAS) as an investigational intervention with unknown utility for patients with transient ischemic attack or stroke.
Larger catheters are stiffer, thus better able to pass through the prostatic urethra.
Getting patients to perform stretching exercises for minor rehabilitation can be problematic, but a physician assistant shares his secret for improving compliance.
Advising patients to take OTC antidiarrheal medications at specific times in relation to when they eat their meals can help reduce the number of bowel movements.
Tenderness over the hypothenar eminence, swelling and limited flexion also suggest fracture.
The number of hospital-acquired MRSA infections is down; however, community-acquired MRSA infections continue to rise.
Does an individual undergoing cataract surgery with standby or local anesthesia need a full workup if he or she has been stable on current medications, regardless of medical history?
After a high-impact fall, a middle-aged firefighter presents with ecchymosis and fixed flexion in the right arm and hand.
What treatment options are available for chronic esophageal reflux? Is surgery ever preferable to long-term treatment with a proton-pump inhibitor?
A gastroenterologist and surgeon have recommended cholecystectomy for a patient with recurrent biliary colic and a 3% biliary ejection fraction on CCK-HIDA scan. Is this advisable?
Can a clinician be sued for battery if a patient objects to a medical treatment, even after giving consent?
A woman fractured her upper arm in a fall while exercising. A large osteolytic growth was discovered on x-ray.
Many dentists, optometrists and other specialty providers are sending adult patients to our primary-care clinic for surgical or procedural clearance. Are there standards of practice for such patients?
Imaging was ordered when the patient's clinician could not palpate her ovaries.
Following gastric bypass surgery, many patients will still need metformin or glipizide (Glucotrol). Is there any evidence that one class of hypoglycemic agents is better absorbed than another?
What vaccines and vaccination schedule are recommended for splenectomy patients?
Do I really need to worry about vials with latex tops or BP cuffs with latex bladders? Can't rash be treated symptomatically, or is escalation to anaphylaxis a major concern?
After developing pancreatitis, the patient was admitted to the hospital and the tumor removed.
Are you a physician assistant contemplating specializing in surgery? Clinical Advisor recently spoke with Michael Doll, MPAS, PA-C, about his career in cardiothoracic surgery.
Previous trials investigating cardiac resynchronization therapy (CRT) (biventricular pacing) combined with an implantable cardioverter defibrillator (ICD) in patients with heart failure have shown nonsignificant improvements in mortality compared with ICD monotherapy. But a newer study has promising results.
General surgery and surgical subspecialties attract a significant number of new physician assistant graduates each year due to the flexibility, variety and dynamic setting the field offers.
I seem to be seeing a lot more hyponatremia. Some of these patients are taking diuretics, while others have psychogenic polydipsia or syndrome of inappropriate antidiuretic hormone secretion (SIADH). Others have no known cause. Is there an explanation for this increase?
Undetected vascular disease reaches its apex while a man is vacationing. Is the on-call clinician to blame?
As a side effect of radical prostatectomy, the favored treatment for many, erectile dysfunction can affect a man's mental and physical quality of life.
The Infectious Diseases Society of America's first treatment guidelines on this topic focus on the management of community-acquired infections.
A woman aged 34 years was referred for treatment of a recurrent, painful, nonhealing ulcer of six months' duration on her left hand.
Commonly found in the oral cavity, HPV lesions may persist or relapse spontaneously and occasionally require surgical excision.
Nothing offered more than temporary relief for the aching, constant pain, which was unaccompanied by other symptoms.
Practical advice to make life easier for patients who wear rigid collars.
Physical exam reveals congenital condition.
Woman refuses to be discharged after a simple stent procedure.
Nurse noted weak heart sounds and large surgical opening after patient underwent appendectomy.
New reports from the National Surgical Adjuvant Breast and Bowel Project B-32 trial show that SLN resection is as effective for survival as ALND and may reduce postsurgical morbidity and symptoms in node-negative women.
A surgical safety checklist developed by the WHO to facilitate communication and safety checks was associated with reduced surgical mortality in a before-and-after study at eight hospitals.
The decision as to when to give blood transfusions is complex, requiring a careful assessment of risks and benefits.
Pulsatile abdominal mass reveals clot in abdominal aorta.
Fast-acting physician assistant saves a life and changes a man's outlook on the world.
A nurse makes a surprise discovery when an obese woman visits the office for a tetanus shot.
Nurses act quickly to reattach a man's scalp.
Do the benefits now outweigh the risks of using lidocaine with epinephrine in digital blocks?
Should a patient with a negative abdominal ultrasound be referred for cholecystectomy?
A boy born with dextrocardia and right pulmonary sequestration gets a new bronchus.
Ms. L, 34 years old and para 1 gravida 2, presented to the emergency room one evening following a four-day battle with "the flu." She became concerned after experiencing increasing pain in her left flank and pelvic area. On questioning, she recounted being constipated and very nauseated.
A 22-year-old female has a loop of bowel around her pancreas and elevated pancreatic enzymes.
Language barriers and financial concerns could have had fatal results, but an insistent nurse prevailed.
A nurse anesthetist's quick reaction saves a patient's life during a routine endoscopic procedure.
After taking all her pills at once, the patient developed dysphagia. But the meds weren't to blame.
Successful treatment can cost tens of thousands of dollars. With limited access to care, these patients often present with advanced disease.
Padding collars with fleece or felt is an inexpensive way to protect pressure areas.
What causes an inclusion cyst to come to a head and rupture, and what effect does this have?
Mistakes are not always the fault of an individual—sometimes, the system is the problem. An expert takes a hard look at what should be done.
A new, minimally invasive approach will decrease morbidity amonghemodialysis patients and help improve their quality of life.
What is the most appropriate choice following replacement with a bioprosthetic valve?
What are the recommendations for using disposable lead wires for postoperative heart patients in the cardiac critical care unit?
When a patient refuses to follow advice, should the clinician be held liable for any adverse outcomes?
The patient's ECG was first interpreted as normal, but he later suffered an MI following surgery.
Not all knee complaints require orthopedic referral. This review of basic testing and exam techniques will help you arrive at an accurate diagnosis.
For moderate-to-severe secondary or idiopathic knee osteoarthritis, the addition of arthroscopic surgery appears no more effective than optimized physical and medical therapy alone.
Perioperative beta blockers have been promoted to reduce the risk for perioperative MI. However, while high-dose perioperative extended-release metoprolol succinate (Toprol XL) for noncardiac surgery decreased MI in high-risk patients, it increased mortality, based on...
With the help of an expert orthopedist and pathologist, a definitive diagnosis was reached in this unusual case.
Dr. P, 45, was a family physician with a suburban practice in the Northeast. He saw a variety of patients but referred many cases that he felt...
The patient continued her aerobic workouts despite persistent chest pressure with an unknown etiology.
Identifying patients at higher risk for mortality and morbidity during the perioperative period can lead to strategies to minimize those risks.
Studies have determined which patients would benefit from spine surgery and which ones would not.