0
This Month in Archives of Surgery |

This Month In Archives of Surgery FREE

Arch Surg. 2002;137(12):1330. doi:10.1001/archsurg.137.12.1330.
Text Size: A A A
Published online

Dr Arthur E. Baue, a former editor of the ARCHIVES and a former Chairman of Surgery at a prestigious medical school, reiterates the feelings of others that there are too many societies, too many meetings, and too many publications of insignificant merit or incompleteness.

As long as personalities, egos, the publish-or-perish mentality, affluence, and money from commercial sources and publishing houses tempt us, restraint is difficult, if not impossible. The only solution appears to be that offered by Hom, Organ, and Twomey (Am Coll Surgeons Bull. 1991;76:23-26), that of merging organizations and publications. Dr Baue concludes with the Harvard Law of Experimentation: "Under controlled conditions, animals and people (and organizations and publishers) behave as they damn well please."

Another report by an author who is very knowledgeable in his field relates to bacterial resistance to antibiotics. Dr Robert E. Condon, a longtime leader in this area and a thoughtful person, looks at the practical aspects of dealing with this problem and makes some important suggestions. He notes that "Bacterial resistance to antimicrobials will always be a problem" and that we now need to "choose novel strategies that have a potential for success."

Schwartz and Tumblin present a review of competitive health care organizations and point out the domination by leaders who practice an outmoded transactional style of leadership that breeds mediocrity and stagnation. They contrast this with entrepreneurship outside the health care sector, emphasizing the characteristics of successful leadership. Their report is well worth reading and pondering.

A COMPARISON OF PERCUTANEOUS CRYOSURGERY AND PERCUTANEOUS RADIOFREQUENCY FOR UNRESECTABLE HEPATIC MALIGNANCIES

Because a large percentage of patients with hepatic malignancy have contraindications to major resection, this article by Adam et al, a highly experienced liver group from Villejuif, France, continues the search for the best ways to manage this difficult group of patients. Owing to the small number of patients involved, it is difficult to make a definitive statement, but it does appear that percutaneous radiofrequency ablation has an advantage in recurrence rate over percutaneous cryosurgery in patients with metastatic but not primary liver cancer.

HAND-ASSISTED LAPAROSCOPIC SPLENECTOMY VS CONVENTIONAL LAPAROSCOPIC SPLENECTOMY IN CASES OF SPLENOMEGALY

In this era of laparoscopic, minimally invasive surgery, elective splenectomy is rarely performed by open technique. However, as Rosen, Ponsky, et al from the Cleveland Clinic, Cleveland, Ohio, report, splenomegaly may preclude safe mobilization and hilar control using a conventional laparoscopic procedure. In a modest series, hand-assisted laparoscopic splenectomy was employed with success for those patients with significantly larger spleens; there was no mortality.

THE USE OF MOLECULAR PROFILING OF EARLY COLORECTAL CANCER TO PREDICT MICROMETASTASES

As a logical extension of the sentinel node mapping technique, Bilchik et al have used molecular profiling in patients with early colorectal cancer. Of 31 patients with negative nodes on hematoxylin-eosin staining, 8 (26%) showed occult micrometastases by immunohistochemical staining, which correlated with the increased presence of tumor markers in the primary lesion.

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.