Operating room injuries: doctors get hurt, too

May 3, 2010 by  
Filed under HEALTHCARE

They play God in the operating rooms. After all, they are holding the scalpel and most often, the patient’s life in their hands. But what we probably don’t know is that surgeons get cut, too, and the operating table is not necessary the most comfortable of all working places. Although most of these are non-serious injuries, they can have some long-term consequences on the surgeon’s health and their ability to practice their profession.

Nowadays, it is standard to use the least invasive procedures when performing a surgery and one of the most commonly used is laparoscopy or popularly known as keyhole surgery. Laparoscopic surgery is used for a wide range of health problems from a simple appendectomy to a radical prostatectomy to remove localized prostate cancer. It has the benefits of increased safety, quicker recovery, shorter hospital stays and cosmetic advantages compared to open surgery techniques. However, these benefits are all on the side of the patient. A large survey of surgeons revealed that about 87% of laparoscopic surgeons are suffering from pain and discomfort when performing these operations, physical symptoms that amount to occupational hazard. It is because performing laparoscopic procedures is less ergonomic than performing an open surgery.

According to lead author Dr. Adrian Park

“In laparoscopic surgery, we are very limited in our degrees of movement, but in open surgery we have a big incision, we put our hands in, we’re directly connected with the target anatomy. With laparoscopic surgery, we operate by looking at a video screen, often keeping our neck and posture in an awkward position for hours. Also, we’re standing for extended periods of time with our shoulders up and our arms out, holding and maneuvering long instruments through tiny, fixed ports.”

Aside from the physical discomfort, laparoscopic surgeons tend to have higher case loads. The resulting physical symptoms include discomfort in the neck, hand, and legs that can result, in the long-term, shortened career longevity.

According to Dr. E. Albert Reece, dean of the University of Maryland School of Medicine.

“The patient has always been the main focus of medicine, as caregivers and researchers grapple with disease treatment and prevention, enhanced patient safety and comfort and the extension of care to more people. At a time when minimally invasive, laparoscopic techniques are expanding, Dr. Park’s research raises new questions that may affect patient care in the future. It is my hope that further research will provide answers, and will help stem what may indeed be an impending epidemic among surgeons.”

Multiple Sclerosis Drug Combined with Lipitor May Stop or Reverse Disease – Dosages Cut in Half with Fewer Negative Side Effects

March 22, 2006 by  
Filed under MULTIPLE SCLEROSIS

March 16th 2006

Combining treatments may improve outcomes for patients with Multiple Sclerosis (MS), according to research done on mice and published online by the Journal of Clinical Investigation. Scott S. Zamvil and colleagues at the University of California, San Francisco found that mice treated with a combination of Glatiramer acetate (GA) and atorvastatin (Lipitor) demonstrated “a significant prevention and reversal of clinical MS severity” of MS symptoms.

Lipitor is a cholesterol lowering drug that has previously been shown to improve MS symptoms. Glatiramer acetate (Teva Pharmaceutical Industries Ltd.’s Copaxone) is a drug currently approved for MS treatment. The researchers found that treating MS with combinations of immune modulating drugs can greatly reduce MS disease.

According to the researchers, treating EAE (experimental autoimmune encephalomyelitis) mice with the combination therapy caused the animals to lose less myelin, prevented CNS inflammation, and MS disease incidence.

The researchers then treated isolated inflammatory cells called macrophages with these drugs and found that the combination therapy mediated its effects by promoting the secretion of the anti-inflammatory molecule IL-10 and suppressed production of the proinflammatory molecules IL-12 and TNF-alpha.

The researchers believe that the combined delivery of drugs, which act through different mechanisms, may enhance the therapeutic efficacy of MS and reduce the negative side effects. Also the drug dosages were less than the dosages used in regular single drug treatments.

Copaxone has been shown to be 30 to 35 percent effective alone. According to Bloomberg News, all MS drugs have to be injected, and have “severe side effects”. None of the MS drugs are very potent.

Lipitor on the other hand can be taken orally and is considered relatively safe. Lipitor, the best selling drug in the world, appears to block production of immune system agents, called cytokines, involved in the disease process. Currently the University of California, San Francisco is looking for 152 patients at 14 hospitals to participate in clinical trials. These trials will investigate the effect Lipitor alone has on MS. Contact the office of Scott Zamvil, associate professor of neurology at University of California, San Francisco, for more information.

There are 400,000 MS sufferers in the US. The illness causes neurological symptoms that include loss of motor control, blindness and temporary recurring paralysis. The condition occur when the body’s natural defenses are over stimulated and begin stripping the protective insulation, called myelin, from nerve fibers in the central nervous system, which includes the brain, optic nerves and spinal cord.

Dan Wilson
Best Syndication

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Copyright 2005 Best Syndication
Last Updated Thursday, March 16, 2006 06:07 PM

Clinical depression is a state of sadness or melancholia

March 6, 2006 by  
Filed under DEPRESSION

Clinical depression is a state of sadness or melancholia that has advanced to the point of being disruptive to an individual’s social functioning and/or activities of daily living. The diagnosis may be applied when an individual meets a sufficient number of the symptomatic criteria for the depression spectrum as suggested in the DSM-IV-TR or ICD-9/10. An individual is often seen to suffer from what is termed a “clinical depression” without fully meeting the various criteria advanced for a specific diagnosis on the depression spectrum. There is an ongoing debate regarding the relative importance of genetic or environmental factors, or gross brain problems versus psychosocial functioning.

Although a mood characterized by sadness is often colloquially referred to as depression, clinical depression is something more than just a temporary state of sadness. Symptoms lasting two weeks or longer, and of a severity that begins to interfere with typical social functioning and/or activities of daily living, are considered to constitute clinical depression.

Clinical depression was originally considered to be a “chemical imbalance” in transmitters in the brain, a theory based on observations made in the 1950s of the effects of reserpine and isoniazid in altering monoamine neurotransmitter levels and affecting depressive symptoms [1]. Subsequent antidepressants have also been found to alter monoamine levels, particularly of serotonin and noradrenaline [2]. Despite a growing body of evidence suggesting otherwise, it is still a commonly held belief that depression is only a chemical imbalance. This idea is often promoted in pharmaceutical advertising, and perpetuated in everyday discussions. Despite this reliance on “common wisdom”, recent research and commentary has begun to address depression as an issue broader than this.

Clinical depression affects about 16%[3] of the population on at least one occasion in their lives. The mean age of onset, from a number of studies, is in the late 20s. About twice as many females as males report or receive treatment for clinical depression, though this imbalance is shrinking over the course of recent history; this difference seems to completely disappear after the age of 50 – 55, when most females have passed the end of menopause. Clinical depression is currently the leading cause of disability in the US as well as other countries, and is expected to become the second leading cause of disability worldwide (after heart disease) by the year 2020, according to the World Health Organization[4].

On a historical note, the modern idea of depression appears similar to the much older concept of melancholia. The name melancholia derives from ‘black bile’, one of the ‘four humours’ postulated by Galen.

The Ebers papyrus (ca 1550 BC) contains a short description of clinical depression. Though full of incantations and foul applications meant to turn away disease-causing demons and other superstition, it also evinces a long tradition of empirical practice and observation.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.