Surgery

Right leg pain after a fall in a patient with a prosthesis

, Major Joseph Alderete, MD May 23, 2012

A 28-year-old female with a history of juvenile rheumatoid arthritis and knee and hip arthroplasty experiences pain after accidentally twisting her right leg.
 

Surgical site infection: Knowledge of the likely pathogens is key

, May 18, 2012

Postoperative complications, including surgical site infections, can prolong hospitalization, delay healing, and increase health care costs.
 

Teams and flow: Learning to lead, follow, or get out of the way

May 17, 2012

A cardiothoracic surgery physician assistant describes what it's like to work in sync with the team: flow.
 

Surgical considerations in invasive breast cancer: A clinician's update

, Amy J. Goldberg, MD, FACS May 10, 2012

Breast cancer requires a multidisciplinary approach in which all clinicians should have a fundamental knowledge of the armamentarium of other team members.
 

Acute appendicitis: Can antibiotics ever take the place of surgery?

, May 02, 2012

Antibiotic therapy eliminates postoperative complications and lowers costs, but the 
methodology of some studies may be weak and the rate of recurrence is high.
 

The question I wish people would ask about cardiothoracic surgery

March 15, 2012

When PAs or PA students are thinking about getting into cardiothoracic surgery, there is one important and telling question that rarely gets asked.
 

Individualizing revascularization 
for peripheral arterial disease

, Anvar Babaev, MD, PhD, FACC March 05, 2012

Severely occluded arteries in patients at high risk of contrast-induced nephropathy require treatment with newer, catheter-based techniques.
 

An internal hernia causes abdominal pain and small bowel obstruction

, Sona James, RN, MA, ACNP-BC, CCRN January 09, 2012

This case of a woman with an internal hernia caused by a small bowel obstruction illustrates a relatively rare condition. Clinician awareness and suspicion are key to a good outcome—left untreated, bowel strangulation is fatal more than 50% of the time.
 

Intrathoracic hemorrhage after placement of a subpleural catheter

, Daniel J. Boffa, MD; Frank C. Detterbeck, MD; Anthony W. Kim, MD November 07, 2011

An already uncommon postoperative complication affects two patients in unusual locations and via different mechanisms.
 

Spearlike chest pain and vomiting in a morbidly obese patient

October 27, 2011

After taking a laxative in preparation for a colonoscopy, a woman with a number of medical problems experiences troubling symptoms.
 

Surgical treatment for osteochondral injuries of the articular knee surface

September 05, 2011

Techniques involving the transfer of osteochondral cylinders and implanting of cartilage cells in areas of damaged cartilage can reduce patients' pain and return them to an active lifestyle.
 

Recurrent pneumonia and fevers in a child with congenital heart disease

August 15, 2011

Sound clinical judgment coupled with diagnostic testing reveal a much more serious cause of a 6-year-old girl's seemingly nondiagnostic symptoms of recurrent fever and cough.
 

Laryngectomy: The silent unknowns and challenges of surgical treatment

August 01, 2011

Patients with laryngeal cancer who decide to have a total laryngectomy face a number of 
difficulties, including loss of speech and the consequent social isolation.
 

Reduced lung function and bullae 
resulting from illicit drug use

Amy L. Jay, PA-C July 25, 2011

A male patient was transferred for evaluation of large left bullae at risk for rupture. CT and history confirmed an interesting cause for the air pockets: marijuana, tobacco, and cocaine use.
 

Mesenteric ischemia: Rapid diagnosis and prompt treatment are essential

, Frank A. Acevedo, PA-C, MS, DFAAPA July 07, 2011

Immediate attention is required if the patient is to have a chance of survival. Critical care, surgical, and vascular consultations should be obtained early in the disease process.
 

Robotics for the surgical treatment of pediatric patients: An overview

June 13, 2011

New robotic surgery systems have broadened the scope of treatment options for pediatrics, allowing surgeons access to a three-dimensional view and the ability to operate remotely.
 

Wireless capsule endoscopy in the 
diagnosis of Crohn disease

, Michael D. Sarap, MD, FACS; Jennifer Childers, MS, PA-C May 23, 2011

In evaluating possible Crohn disease, capsule endoscopy is effective at showing the entire small bowel and tracking the progression of healing.
 

Evaluation and surgical management of melanoma of the head and neck

, Michael Kupferman, MD April 18, 2011

This article provides a review of cutaneous melanoma, including preoperative evaluation, surgical procedure, and adjuvant therapy.
 

Radiofrequency ablation as treatment 
for chronic venous insufficiency

, Brian G. Rubin, MD March 21, 2011

In the past, this disease was treated with painful surgery. Today, new minimally invasive technology has revolutionized treatment.
 

Deep brain stimulation: A review of the procedure and the complications

, February 14, 2011

DBS is no longer experimental, and this treatment is becoming more common. PAs should be prepared to care for these implant patients.
 

Esophageal carcinoma: Matching 
patients with treatment methods

, Richard T. Miller, MD January 18, 2011

Since cancer of the esophagus has a high morbidity and mortality, choosing the correct treatment method and knowing the facts are key.
 

Iatrogenic retention of surgical objects: Risk factors and prevention strategies

December 13, 2010

Recent changes in government payment policy may make this serious and costly medical 
error even more expensive. Most prevention strategies appear to be cost-effective.
 

Small bowel necrosis in association with jejunal tube feeding

Andrea N. Sarap, PA-C; Michael D. Sarap, MD, FACS; Jennifer Childers, PA-C November 15, 2010

Despite successful gastrojejunostomy reconstruction and jejunal feeding tube placement, this patient died from a rare complication.
 

What's new in minimally invasive surgery: 
Robotic technology speeds recovery and improves outcomes

October 21, 2010

A new robotic surgery technique offering surgeons greater flexibility and precision decreases the patient's recovery time and risk of complications.
 

A Day in the Life: Nicole Larson, MPAS, PA-C

October 19, 2010

A PA who practices in thoracic surgery describes a busy day in the hospital and the clinic.
 

Hyperglycemia management in 
the urgent surgical patient

September 27, 2010

Stress-induced hyperglycemia presents a unique challenge. Avoidance of extreme fluctuations in blood glucose levels is critical.
 

Hip resurfacing: A fresh look at an alternative to total joint arthroplasty

, Jackie H. Coleman, CST September 02, 2010

Improved devices make the procedure a viable option for a select group of patients with hip arthritis.
 

Collis-Nissen fundoplication for a symptomatic paraesophageal hernia

Ashley L. Racette, PA-C, MPAS; Richard T. Miller, MD July 12, 2010

A laparoscopic approach leads to relief of the patient's gastroesophageal reflux, uneventful surgery, and a smooth recovery.
 

What is the significance of this patient's pulsatile tinnitus?

Jason C. Fowler, MPAS, PA-C; Barry E. Hirsch, MD; Peter F. White, MD, FRCS June 28, 2010

Symptoms were worse when she tried to sleep, but there was no associated dizziness, vertigo, or otalgia.
 

Mediastinal mass in a patient with a history of bypass surgery

June 14, 2010

Nonproductive cough and pleuritic chest pain with a history of chronic obstructive pulmonary disease lead to a surprising diagnosis.
 

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