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From Antiseptic to Aesthetic: Experience as a New Narrative In Curative Care
Published in Frederick J. DeMicco, Ali A. Poorani, Medical Travel Brand Management, 2023
Medical records from the asylum reveal the medical history of Alice, a young patient who was diagnosed with epilepsy. By modern standards, epilepsy is understood as a neurological disease characterized by uncontrollable seizing, but in the late 1800s, epileptic patients were viewed as insane. Medical notes document her time as a patient and her eventual recovery. Genealogical records suggest she may have married in Michigan several years later and died in Los Angeles in 1943 at the age of 80 (Ziff, 2012). We have no way of knowing whether the moral experiment directly contributed to Alice’s outcomes, but we can be fairly certain that compassionate treatment can be efficacious.
Telescopes for Inner Space: Fiber Optics and Endoscopes
Published in Suzanne Amador Kane, Boris A. Gelman, Introduction to Physics in Modern Medicine, 2020
Suzanne Amador Kane, Boris A. Gelman
More speculative uses of endoscopy are being explored by the medical profession, including a new method for abdominal surgery that avoids external incisions altogether. Called Natural Orifice Translumenal Endoscopic Surgery, or NOTES, these procedures instead involve surgery performed by endoscopes inserted through the mouth or anus and incisions made through the stomach or colon wall. The surgical procedure then is performed with the endoscope being threaded internally to the site of surgery, for example, for gallbladder removals. Why might this be advantageous? Cutting the skin and the walls of the abdomen in open or laparoscopic surgery excites a vigorous emergency response, including triggering nerves, the immune system, and chemical messengers that promote the body's defenses – but the same is less true for internal incisions. Thus, NOTES holds out the prospect of surgery with minimal pain, no need for general anesthesia, no external scarring, and reduced recovery time.
Dialogues from the field
Published in Sally G. Warmington, Storytelling Encounters as Medical Education, 2019
However, the use of hand-written notes alone has limitations. The precise details of an interaction cannot be reliably captured, and as a result some analytic techniques which can be used on audio-recorded data cannot be applied to material recorded in this way. Despite the challenges, I was able to record sufficient detail to allow detailed descriptions and interpretations. I believe that my capacity for close observation and retention of detail, developed over many years of clinical work, helped me in this research context (Murchison, 2010). Other researchers have successfully employed audio and video recording devices in hospital settings, resulting in valuable additional data (Iedema et al., 2006; Liu et al., 2012; Monrouxe, Rees, & Bradley, 2009).
ChatGPT and Ophthalmology: Exploring Its Potential with Discharge Summaries and Operative Notes
Published in Seminars in Ophthalmology, 2023
Swati Singh, Ali Djalilian, Mohammad Javed Ali
The operative notes were detailed and were produced in less than 20 seconds following the prompt. ChatGPT divided the operative notes into pre- and post-operative diagnosis, procedure, anesthesia, indication, procedure details, post-operative care, estimated blood loss, complications, and summary (Tables 3 and 4). It is interesting how randomly ChatGPT assumes certain aspects of the prompt and takes a call itself. For example, the prompt in Table 3 mentioned multifocal IOL only. However, ChatGPT decided on its own that it is Acrysof IQ PanoptixR multifocal IOL and responded accordingly in the operative notes! ChatGPT’s ability to admit mistakes and learn quickly from them could be well appreciated. For example, after providing operative notes for intraocular injection of Ranibizumab (Table 4), ChatGPT was confronted with a counter question ‘I do not think patients are given adequate sedation before intraocular injection of Ranibizumab. Are you sure about this?’ (Table 5). ChatGPT immediately apologized for this error, learned quickly, and when prompted again after some time about operative notes for intraocular injection, the sedation error was corrected (Table 5). Like discharge summaries, several shortcomings were apparent in all the operative notes. However, ChatGPT can be quickly trained to customize it to the user needs.
A chronicle of the pancreatoduodenectomy technique development – from the surgeon’s hand to the robotic arm
Published in Acta Chirurgica Belgica, 2023
Marek Olakowski, Beata Jabłońska, Sławomir Mrowiec
Recent historical research indicates that the first, although unsuccessful, operation of pancreatic head resection with the duodenum was performed by Alessandro Codivilla (1861–1912), an Italian born in Bologna in 1861. The operation took place in a hospital located in Imola probably on February 9, 1898. Although from the documentation left in the annual medical report dated 1899 it is not clear whether the patient was exactly operated. There is only the date of his admission and death after 21 days of hospitalization. Nevertheless, the found handwritten notes leave no doubt about the diagnosis - cancer of the stomach and pancreas and the range of the operation - resection of a part of the stomach, duodenum and pancreas, cholecystoenterostomy and gastroenterostomy. In the description of the operation, there is no information about the supply of the pancreatic section - either it remained unsupplied or was sutured. For some, this document is evidence of the first description of open pancreatoduodenectomy (OPD) and its date marks the beginning of the era of modern pancreatic surgery [4,5].
Surgical outcomes and prognostic factors of parasagittal meningioma: a single-center experience 165 consecutive cases
Published in British Journal of Neurosurgery, 2022
Bo Wang, Gui-Jun Zhang, Zhen Wu, Jun-Ting Zhang, Pi-Nan Liu
Damage to the venous system (superior sagittal sinus and bridge cerebral veins) might have disastrous consequences. Preservation of the venous system was tightly associated with the safe surgery of superior PSMs, which must be preserved at all costs. Tumour removal with Simpson grade I resection was not recommended if an important venous system could not be maintained. Several surgical notes were recommended.8,9 (1) Craniotomy was performed in a standard way and at least two burr holes at each side of the sinus, which could decrease the damage of the superior sagittal sinus. (2) The packing of an appropriate gelatin sponge along the burr holes was conducive to separating the dura and skull bone, particularly in tumours with strong adhesion. (3) The skull cutting that crossed the superior sagittal sinus should be the last step performed. In the case of sinus laceration, the bone flap could be quickly elevated and fixed to the injured sinus.10 (4) All of the bridge cerebral veins were preserved as far as possible, especially if involving the middle third of the superior sagittal sinus.10 (5) The technique used for controlling exudation from the sinus was sponge haemostasis through compression rather than bipolar coagulation.