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Industry Payments to Physicians
Published in Charles E. Dean, The Skeptical Professional's Guide to Rational Prescribing, 2022
Unfortunately, the extra dose of sunlight appears to have had effect on Pharma and physicians. In 2015, 48% of the physicians in the United States received $2.4 billion in payments, of which only $75 million was aimed at research, while $544 million went to ownership interests.10 The largest chunk, $1.8 billion, went to so-called general (non-research) payments, with 87% of that money going for food and beverages, and $484 million for license or royalty payments. While the mean payment per physician was only $201, surgeons received $6,879, and males received higher levels of payments than females in each specialty. While the $201 payment at first glance appears inconsequential, Dejong et al.6 found in 2016 that recipients of even a single meal, set in the context of promoting a specific drug, went on to prescribe that drug at a statistically significantly higher rate than a similar agent. This held true for statins, ß-blockers, and antidepressants.
Acute Care Emergency Surgery
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Marcelo A. F. Ribeiro, Mansoor Khan
Inguinal hernia repair is among the most common procedures performed by the general surgeon. There are two types: indirect and direct. Indirect hernias develop at the internal ring, where the spermatic cord or the round ligament enter the inguinal canal. They originate lateral to the inferior epigastric vessels – in contrast to the direct hernias which protrude through Hesselbach’s triangle (rectus abdominis muscle medially, the inguinal ligament inferiorly, and the inferior epigastric vessels laterally) medial to the inferior epigastric vessels.
The impact of organisational culture on those working in health and social care
Published in Janet Thomas, Understanding and Supporting Professional Carers, 2021
Established professions such as medicine, nursing and social work have evolved over many decades. People who performed the same kind of work started to be known by certain labels. Descriptive labels changed as the nature of the job changed, or as fashions changed. Almoners, or dispensers of alms, became social workers. Distributing alms is not what they do any more. Barbers became surgeons. Now surgeons are subdivided into specialties according to which parts of the body they operate on. Groups of professionals exchanged or shared information and defined their areas of expertise. This expertise became a precious commodity that had to be protected, so entry to the group became a privilege restricted to those who fulfilled certain criteria. Once entry is restricted, a select group is needed to set entry conditions and determine who can join. Members must continue to meet the prescribed standards in order to maintain the security and the reputation of the group. Professional standards are also important for protecting the users of the services.
Effects of hepatocyte growth factor-transfected mesenchymal stem cell transplantation in canine injured vocal folds
Published in Growth Factors, 2023
Xingqiao Xie, Xumao Li, Xinsheng Lin, Xiangyu Chen, Chenshan Zhang, Guangbin Sun
All animals received humane care in compliance with the National Institutes of Health guide for the care and use of laboratory animals (NIH Publications No. 8023, revised 1978). All animal studies were performed according to a protocol approved by the Institutional Animal Care and Use Committee of Fudan University (No. 20160830A209). In total, 16 adult beagles weighing 10–15 kg were used in this study. Among those, 12 beagles were randomly assigned to three groups. The dogs were anesthetized with intravenous injection of 3% pentobarbital sodium (1 ml/kg) and supplemented as needed during the operation. The 12 beagles underwent transoral laser microsurgery (subligamental cordectomy, type II) using CO2 laser (UltraPulse, 2 W, 0.1 s). The CO2 laser used in this study was the DEKA SmartXide2 C60 (Calenzano, Italy). An experienced surgeon performed the surgeries. The control group received unilateral cordectomy, while the two other groups received bilateral injury. Four weeks later, HGF-transfected ADSCs and untransfected ADSCs (0.2 ml, 3 × 106 cells) were injected into both sides of the VF lamina propria with a Bruning syringe (27200, KARL STORZ, Tuttlingen, Germany, Figure 1(A,B)), based on the respective groups. Transoral laser microsurgery was also performed on the remaining four beagles, as mentioned above, and the bilaterally injured VFs were injected with HGF-transfected ADSCs after four weeks. These four beagles were sacrificed in the 2nd week, 1st month, 2nd month, and 3rd month, respectively, and immunofluorescence was used to detect the persistence of HGF-transfected ADSCs.
When Surgeons Are “Too Old” to Practice Surgery: Recommendations to Balance the Imperatives of Public Safety and Practical Necessity
Published in Hospital Topics, 2023
Mark Cwiek, Dan J. Vick, Krista Osterhout, Vincent Maher
States, as sovereign political entities, even if members of larger confederated political systems, typically regulate in collaboration with the targeted professions the criteria for initial licensure and the maintenance of licensure thereafter. It is in society’s best interest that the requirements for licensure are viewed through the lens of the promotion of public safety. Medical licensure laws commonly require professional education in an accredited school followed by post-graduate training in an approved residency program, the successful passing of licensure exams, and attendant initial licensure as a physician and surgeon. The licensee determines the nature of the practice to be entered into and elects specialized post-graduate training in that area of medicine followed, or not, by medical specialty board certification.
Effect of perineural bupivacaine infiltration on reducing inguinodynia in patients undergoing inguinal meshplasty – a randomized controlled trial
Published in Acta Chirurgica Belgica, 2022
Angeline Mary Samy, Amaranathan Anandhi, Gubbi Shamanna Sreenath, Sathasivam Sureshkumar, Srinivasan Swaminathan
Demographic and clinical details were collected. Intraoperatively, the operating surgeon noted the type of hernia, extent of hernia, and sac excision. Pain was assessed at 3 h and 6 h post-surgery, using the Wong-Baker faces pain scale. The primary investigator of the study assessed the post-operative pain score. All the patients in both groups received tablet Paracetamol 500 mg thrice daily on postoperative day one and two. The postoperative pain scores were collected at 3 h after surgery and 6th hourly for 24 h using Wong- Bakers face pain scale. Patients who had a score of 4–6 were given ketorolac injection intramuscularly and patients who had a score >6 were given Tramadol, intravenously. At the end of 3 months, the patients were called over the telephone and asked for the presence of groin discomfort or pain.