Canadian Journal of Surgery articles from August 2005

Canadian Journal of Surgery archives from August 2005

Informed consent/Consentement eclaire.(Editorial)
August 1, 2005... In this issue (Can J Surg 2005;48: 271-2), Bernstein provides a provocative view of the consent process involved in randomized clinical trials. He argues, with some success, that patient consent in randomized clinical trials is not truly...

Fully informed consent is impossible in surgical clinical trials.(Quill on Scalpel/Plume et scalpel)
August 1, 2005... Clinical trials are a cornerstone of advancing quality in all areas of medical practice. They may be especially challenging in surgical specialties where potential risks of surgery, including novel interventions, can be catastrophic. Yet they...

Bilateral total knee arthroplasty--staged or simultaneous? Ontario's orthopedic surgeons reply.(Original Article/Article original)
August 1, 2005... Background: Total knee replacement is now the most common joint replacement procedure performed in Ontario, and many patients require bilateral replacement. However, whether bilateral total knee arthroplasty (TKA) should be staged or...

Efficacy and safety of controlled-release oxycodone and standard therapies for postoperative pain after knee or hip replacement.(Original Article/Article original)
August 1, 2005... Background: Standard therapy (ST) for postoperative pain after knee and hip replacement at the Hamilton Health Sciences Henderson Hospital consists of epidural analgesia or patient-controlled analgesia for the first 48 hours, followed by oral...

Penetrating thoracoabdominal injuries in Quebec: implications for surgical training and maintenance of competence.(Original Article/Article original)
August 1, 2005... Background: The frequency of penetrating trauma is low in Canada. Current recommendations for the care of patients with penetrating injuries originate from inner city trauma centres with a high volume of such injuries and may not apply to...

Population-based study of severe trauma due to electrocution in the Calgary Health Region, 1996-2002.(Original Article/Article original)
August 1, 2005... Background: Severe trauma arising from electrocution is uncommon, and we wished to study the incidence, risk factors and outcome to identify potential areas of prevention. We therefore studied an active population of adult victims of severe...

Endovascular management of traumatic thoracic aortic injuries.(Original Article/Article original)
August 1, 2005... Background: Endovascular surgery has recently been extended to the treatment of blunt traumatic aortic injuries. Since most of these injuries occur at the aortic isthmus, graft fixation in proximity to the origin of the left subclavian artery...

2004 MacLean-Mueller prize enteral or parenteral nutrition for severe pancreatitis: a randomized controlled trial and health technology assessment.(Original Article/Article original)
August 1, 2005... Background: The optimal route of nutrition in severe pancreatitis is controversial. Parenteral nutrition (PN) is preferred, but enteral nutrition (EN) promises to attenuate inflammation and prevent sepsis. We hypothesized that EN was at least...

Minimally invasive direct coronary artery bypass for the treatment of isolated disease of the left anterior descending coronary artery.(Original Article/Article original)
August 1, 2005... Background: Treatment of isolated stenosis or occlusion of the left anterior descending (LAD) coronary artery through a left anterior mini-thoracotomy has only recently been advocated as an acceptable alternative to standard coronary artery...

Current status of Canadian vascular surgery training: a survey of program directors.(Original Article/Article original)
August 1, 2005... Background: With the aging of the North American population and therefore the need for more modern vascular surgeons familiar with open operations and less invasive diagnostic and therapeutic regimens, we wished to obtain suggestions and...

Cardiac allograft vasculopathy: a review.(diagnosis and treatment)
August 1, 2005... Cardiac allograft vasculopathy (CAV) is a major factor limiting long-term survival after cardiac transplantation. CAV is an accelerated form of coronary artery disease (CAD) that is characterized by concentric fibrous intimal hyperplasia along...

Surgical images: musculoskeletal: giant cell tumour of the sacrum.(Continuing Medical Education/Formation medicale continue)
August 1, 2005... A 23-year-old man presented with a 6-month history of progressive lower back pain. Three months earlier, the pain had started radiating into his legs, with numbness in the perineal area. Constitutional symptoms included night pain and a 9.1-kg...

Missile wounds of the femoral head in children.(Case Notes/Notes de cas)
August 1, 2005... Missile trauma in children is uncommon, but its incidence has risen over the past decade primarily owing to the increased availability of guns and the many armed conflicts occurring in various parts of the world. (1,2) Such injuries in children...

Duodenal diverticulum with retroperitoneal perforation.(Case Notes/Notes de cas)
August 1, 2005... Duodenal diverticulum is a common condition, but the rare complication of perforation carries a high mortality, requiring early detection and treatment. We describe a case of a patient with a perforated diverticulum to illustrate the radiologic...

Pain relief.(Correspondence/Correspondance)(Letter to the Editor)
August 1, 2005... I hope that all hospitals will follow the example of St. Michael's Hospital, Toronto, and have pain services work with the surgical teams as described in the Quill on Scalpel article in the April issue (Can J Surg 2005; 48:98-9). I support the...

On dissatisfaction.(Correspondence/Correspondance)(Letter to the Editor)
August 1, 2005... I read with interest the editorial entitled "Dissatisfaction: how it has grown" (Can J Surg 2005;48:93-4). I believe that the points made are valid. There are additional factors affecting the surgical workforce and its future planning. With...