Modern concepts of hepatic insufficiency, their advantages and faults: views of a general surgeon and transplantologist

ABSTRACT A testosterone test using two different dosages was carried out simultaneously in 7 women suffering from metastasizing carcinoma of the mamma and in 3 normal women. In each case the urinary steroids were estimated before the beginning of the test and after administration of 50 mg and 100 mg of testosterone respectively; the interval between the single estimations being one week. The use of fractionated hydrolysis enabled a mild fission of the conjugates and the classification of the products into free steroids, glucuronosides, sulfates and unknown conjugates. The 17-ketosteroids and the testosterone were estimated by means of Girard's separation and adsorption chromatography. During the loading test with testosterone different behaviours became evident, which had not been realized before. The behaviour of the 17-ketosteroids rendered possible the differentiation of normal women from patients with cancer of the breast yet without hepatic insufficiency, and furthermore of these latter ones from those with a liver damage in addition to the cancer of the breast. The glucuronosides of the 17-ketosteroids are only depressed, when there exists a pronounced damage of the liver; the loading test making possible an extension of the range of recognizable damages. Furthermore, the behaviour of dehydroepiandrosterone (II/III), of androsterone (IV), and of aetiocholanolone (V) lends itself to this differentiation. In advanced cancer of the breast the values of II/III are invariably low, whilst IV and V often increase temporarily. The relation of IV to V may be altered in a different way. The excretion of not transformed testosterone is less in patients than in normal women and especially low in patients with liver damage.

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Application of social media in the education of the general surgeon. @Cirbosque, breaking the paradigm

Cirugía Andaluza ◽

10.37351/2020311.2 ◽

2020 ◽

Vol 31 (1) ◽

pp. 15-20 ◽

Cited By ~ 1

Author(s):

LF Cabrera Vargas ◽

G Herrera ◽

A Mendoza Zuchini ◽

M Pedraza ◽

S Sánchez ◽

...

Keyword(s):

Social Media ◽

General Surgeon ◽

Redes Sociales ◽

Twitter Analytics ◽

Educación Virtual

Resumen En el campo de la medicina las redes sociales han ganado poco a poco terreno y hoy en día juegan un rol importante en el aprendizaje y la enseñanza de conocimientos que se pueden trasmitir de inmediato y de forma masiva. El objetivo de este artículo es mostrar la experiencia colombiana en el uso de las redes sociales para crear aprendizaje quirúrgico significativo, con liderazgo y tutoría global. Se llevó a cabo un estudio descriptivo retrospectivo desde la creación de nuestras redes sociales en Twitter, 22 de febrero al 22 de agosto de 2019, evaluando las siguientes variables: número de tweets académicos, número de seguidores, impresiones, visitas y menciones. Desde la creación de nuestra red social Twitter @Cirbosque para realizar educación virtual quirúrgica a través de redes sociales con el fin de generar un aprendizaje significativo en nuestros seguidores, en solo seis meses del proyecto, seguimos a 62 cuentas, hemos realizado hasta la fecha 5.025 tweets académicos, con un crecimiento del 77,1% mensual, con 2.203 seguidores, con un crecimiento del 426 seguidores mensual, 1.090.000 impresiones, con un crecimiento del 56% mensual, 13.500 mil visitas, con un crecimiento del 28,9% mensual y 2.028 menciones, con un crecimiento del 88,3% mensual. Aunque la evidencia aún es insuficiente para garantizar que la educación que se hace a través de redes sociales y de @Cirbosque sea eficiente, el impacto que ha tenido esta iniciativa en Twitter es apreciada por muchos cirujanos a nivel mundial incluyendo a grandes maestros referentes en cada uno de los temas que se han tratado, de la misma forma, la cantidad de participantes en las diversas discusiones planteadas día a día y con un incremento en todos los indicadores de impacto según Twitter Analytics, se puede deducir que el mensaje educativo está teniendo un efecto positivo y está llegando a miles de personas a nivel mundial.

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HAEMOCLASIC CRISIS AS A TEST OF HEPATIC INSUFFICIENCY

BMJ ◽

10.1136/bmj.1.3248.574-b ◽

1923 ◽

Vol 1 (3248) ◽

pp. 574-574

Author(s):

R. Chalmers

Keyword(s):

Hepatic Insufficiency

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929 Not Another Abscess - A Case of Streptococcal Myositis Misdiagnosed as a Right Axillary Abscess

British Journal of Surgery ◽

10.1093/bjs/znab134.176 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

O Oyende ◽

J Jackman

Keyword(s):

White Cell Count ◽

General Surgeon ◽

High Dose ◽

General Anaesthetic ◽

Microbiological Analysis ◽

Reactive Protein ◽

Affected Tissue ◽

Life Threatening ◽

History Of ◽

High Degree

Abstract Introduction Streptococcal myositis is a rare form of infectious myositis caused by Lansfield A beta-haemolytic streptococci. It is characterised by rapidly spreading inflammation that can result in severe systemic toxicity and necrosis of the affected tissue if not diagnosed and aggressively treated. Presentation We report a case of a 42-year-old male who presented with a one-week history of worsening right axillary swelling that progressed to painful swelling of his arm. Inflammatory markers were significantly elevated with a white cell count of 17 ×109/L and C-reactive protein of 212 mg/L. On examination, a fluctuant axillary swelling was appreciated, and a decision was made for incision and drainage under general anaesthetic. Intraoperative aspiration of his arm revealed copious purulent fluid prompting intraoperative orthopaedic consult and exploration of the anterior compartment in which there was extensive involvement of the biceps muscle. The microbiological analysis revealed gram-positive cocci in chains, and microbiology advice sought for tailoring of antibiotic regimen. He has recovered well. Discussion Though uncommon, the emergency general surgeon should have a high degree of suspicion when evaluating soft tissue infections to avert potentially disastrous outcomes. Conclusion Early diagnosis, aggressive management with high-dose intravenous antibiotics, and surgical debridement are principles to treat this rare, life-threatening infection.

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A Critical Viewpoint by a General Surgeon Toward Reconstructive Surgery After Mastectomy

Clinics in Plastic Surgery ◽

10.1016/s0094-1298(20)32088-5 ◽

1979 ◽

Vol 6 (1) ◽

pp. 15-17 ◽

Cited By ~ 2

Author(s):

Louis J. Lester

Keyword(s):

Reconstructive Surgery ◽

General Surgeon

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Variable Symptomatology in Idiopathic Retroperitoneal Fibrosis

Journal of the Royal Society of Medicine ◽

10.1177/014107688307601209 ◽

1983 ◽

Vol 76 (12) ◽

pp. 1023-1025 ◽

Cited By ~ 2

Author(s):

C D M Fletcher ◽

P E M Jarrett

Keyword(s):

Retroperitoneal Fibrosis ◽

District Hospital ◽

Differential Diagnoses ◽

General Surgeon ◽

Idiopathic Retroperitoneal Fibrosis

Idiopathic retroperitoneal fibrosis is uncommon enough to be placed low down on a list of differential diagnoses of any problem facing a general surgeon in a district hospital. In this paper, 4 cases of retroperitoneal fibrosis are described, all of whom presented within a 5-year period to the same surgeon; each described a different symptomatology. This paper serves to reiterate the diversity of presenting features in retroperitoneal fibrosis and to demonstrate that this condition may not be as rare as is widely believed.

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