Singer, M. et als.
JAMA. 2016; 315(8):801-810
Definitions of sepsis and septic shock were last revised in 2001. Limitations of previous definitions included an excessive focus on inflammation, the misleading model that sepsis follows a continuum through severe sepsis to shock, and inadequate specificity and sensitivity of the systemic inflammatory response syndrome (SIRS) criteria. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.
With the popularity of cosmetic surgery procedures, it is vital that the surgeon select patients for procedures who likely will benefit, handle stress in a healthy manner, and not pose an undue level of aggravation to the surgeon and staff. By using a carefully planned preoperative written assessment, the surgeon can help identify patients who, for psychologic reasons, are emotionally suitable for such surgery.
The objective of this review was to systematically examine whether there is clinical evidence to support recommendations for positioning patients with acute burn. Review of the literature revealed minimal evidence-based practice regarding the positioning of burn patients in the acute and intermediate phases of recovery. This manuscript describes recommendations based on the limited evidence found in the literature as well as the expert opinion of burn rehabilitation specialists. These positioning recommendations are designed to guide those rehabilitation professionals who treat burn survivors during their acute hospitalization and are intended to assist in the understanding and development of effective positioning regimens.
Late haematomas and seromas (≥4 months postoperatively) in breasts with silicone prosthesis have been reported. Since 2001, there have only four patients with such delayed complication visiting our hospitals. The purpose of this literature review and our case presentation is to have more understanding about the clinical symptoms, surgical managements and relationship with implants for this late complication.
Rhytidectomy remains a challenging surgical procedure for even the most experienced aesthetic plastic surgeons. The challenges are compounded by complications that are inherent to this procedure and place added pressure on the doctor-patient relationship. Expectations for both parties are high and the margin for error nil. This article presents a personal approach to the avoidance and management of complications associated with facelift surgery. It presents the author’s personal approach as a plastic surgeon in the practice of aesthetic plastic surgery over the past 25 years. Clinical pearls are provided to obtain optimum results in rhytidectomy and limit associated sequelae.
The latest iteration in the Sherlock Holmes movies arrived in America on Christmas Day. Digital effects allowed its director, Guy Ritchie, to have slow motion sequences that showed how Holmes used his senses to deduce facts about other characters. Holmes was a fictional detective, but we plastic surgeons are fortunate to have been taught Gillies’ principle ‘Observation is the basis of surgical diagnosis.’ This was Gillies’ first principle and the basis of his others. He believed that without a proper diagnosis surgical disaster loomed and went so far as to say, ‘Mistakes in diagnosis due to inadequate examination are perhaps the commonest cause of indifferent treatment’.
Sitio web publicado el
Los lectores comentan