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Research Article  |   Volume 1, Issue 2

Monitoring of the Left Recurrent Laryngeal Nerve during Mediastinoscopy is Feasible and Safe

Wolfram Karenovics, Sebastien Guigard, Besa Zenelaj, Marc Licker and Frederic Triponez
Abstract

Objective: Left Recurrent Laryngeal Nerve (RLN) palsy is a well known complication of cervical mediastinoscopy and is not infrequent if specifically looked for. Electro-physiological monitoring of the RLN is common practice in thyroid surgery and has greatly improved outcomes. We applied the same technique during cervical video-mediastinoscopy. Patients and methods: Between October 2012 and October 2013 patients undergoing mediastinoscopy were enrolled prospectively for intra-operative monitoring of the left RLN. A standardized protocol for the use of the neuromonitor was followed.

  PDF   |    Full Text | DOI: 10.23937/2378-3656/1410012

Research Article  |   Volume 1, Issue 2

Cancer Disease: A New Hypothesis of Interpretation and Therapeutic Approach

G. Di Donna and R. Di Muro
Abstract

The authors propose a new research hypothesis about cancer pathology, starting from the hypothesis of considering cancer as a process of adaptation to changed conditions, which can be internal or external to the organism, with the aim of reaching the survival of the species. The authors, in the present work, put forward an hypothesis which is based on the observation of natural phenomenon, referred to the previously described mutations, some as natural evolutionary phenomena which are genetically transmitted as a result of environmental adaptation (for example the color of the skin), some others, with the same modalities, as pathological phenomena (for example thalassemia), some others as more flexible environmental responses (for example human height in relation with the improved food conditions), some others as immediate responses of the organism in order to defend its own biological integrity and individuality (for example violent anaphylactic reactions which happen as consequences of extraneous proteins introduction).

  PDF   |    Full Text | DOI: 10.23937/2378-3656/1410011

Case Report  |   Volume 1, Issue 2

Breast Augmentation by Vaseline Oil: A Case Report of Still a Dangerous Practice

Remi Foissac, Olivier Camuzard, Jonathan Fernandez, Thierry Balager and Berengere Chignon-Sicard
Abstract

Injection of mineral oils for breast augmentation has disappeared in most developed countries for over 40 years because of major complications secondary to its infiltration in breast tissue. We present the case of a woman of 32 years old, who had received intramammary massive injections of vaseline oils 2 years ago with important breast pains. The management was surgical with excision of maximum of vaseline nodules and immediate reconstruction with a subpectoral implant covered up at its lower part by a desepidermised dermal flap. This devastating practice is still performed in some countries by unconscious persons and raises the complicated problem of breast reconstruction and monitoring. This case report remains that this practice should be considered in front of a patient with an unknown injection of volumizing substance in the breast. Partial subcutaneous mastectomy that preserves vaseline nodule close to the skin allows to avoid pitfall of secondary exposure of the implant. Evidence based-medicine: Level V

  PDF   |    Full Text | DOI: 10.23937/2378-3656/1410010

Case Report  |   Volume 1, Issue 2

Symptomatic Phytobezoar Presenting 5 Years after laparoscopic Rouxen-Y Gastric Bypass

Adeleke Adesina, Farook Taha, Adeshola Fakulujo, Alex Gandsas and Rebecca Jeanmonod
Abstract

There are over 100,000 bariatric surgeries in the United States each year, with the majority of these Roux-en-Y procedures. Most complications of this surgery present early with nonspecific symptoms such as abdominal pain, nausea, vomiting, and dysphagia. Some complications, however, can occur years after surgery. We report the case of a patient presenting 5 years after laparoscopic Roux-en-Y gastric bypass (LRYGBP) with intermittent abdominal pain, vomiting, and local bowel ischemia secondary to phytobezoar lodged at her jejuno-jejunostomy site.

  PDF   |    Full Text | DOI: 10.23937/2378-3656/1410009

Case Report  |   Volume 1, Issue 2

First Bite Syndrome: An Underestimated Complication of Carotid Body Tumor Surgery

Dilek Yilmaz and Jaap F. Hamming
Abstract

Carotid Body Tumours (CBTs) are paragangliomas located at the carotid bifurcation, treated surgically or by follow-up. First Bite syndrome (FBS) is a rare complication of CBT surgery, with only a few reports in literature. We present a case of a 34-year-old female patient who developed FBS after CBT surgery to raise awareness for this rare and underestimated complication affecting quality of life.

  PDF   |    Full Text | DOI: 10.23937/2378-3656/1410008

Research Article  |   Volume 1, Issue 2

General Practitioners' Willingness to Pay for Continuing Medical Education in A Fee-for-Service Universal Coverage Health Care System

Shahzia Lambat Emery, Reto Auer, Nicolas Senn, Isabella Locatelli and Jacques Cornuz
Abstract

Background: Sponsoring of medical meetings by life science companies has led to reduced participation fees for physicians but questions potential drawbacks. Ongoing discussions are proposing to ban such sponsoring which may increase participation fees. Objectives: To evaluate factors associated with general practitioners' willingness to pay for medical meetings, their support of a binding legislation prohibiting sponsoring and their opinion on alternative financing options. Methods: An anonymous web-based questionnaire was sent to 447 general practitioners' of one state in Switzerland, identified through their affiliation to a medical association. Results: Of the 115 physicians answering, 48% were willing to pay more than what they currently pay for medical meetings and 79% disagreed that sponsoring introduced a bias in their own prescription practices.

  PDF   |    Full Text | DOI: 10.23937/2378-3656/1410007