Month: March 2018

ACUTE CARE SURGERY

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As medicine changes and modernizes, new specialties arise. General surgery is seeing new fields emerge. One is acute care surgery. Acute care surgery is an evolving specialty with three essential components – trauma, critical care, and emergency surgery.  Acute care surgeons provide multidisciplinary care for patients who require emergency surgery because of an accident or sudden illness. This care continues throughout the patient’s hospitalization and following discharge.

These changes in surgery are in response to a number of forces. General surgeons are becoming increasingly more focused, especially in areas such as advanced laparoscopic surgery, bariatric (obesity) surgery, endovascular surgery, and breast surgery. With these areas of concentration, come less interest in being on call for emergencies (especially during “off” hours), which can interfere with other, non-emergency cases and office practice. In addition, many trauma surgeons wish to increase their operative case load because trauma care itself has become less involved with operative procedures.

As this specialty has grown, acute surgical emergencies often represent the most common reason for hospital admission. These conditions include, but are not limited to: acute appendicitis, cholecystitis or gallbladder disease, diverticulitis, pancreatitis, intestinal obstruction, intestinal ischemia, intra-abdominal sepsis, incarcerated hernias and perforated viscous.

Acute care surgery integrates the long-established field of trauma surgery with the management of general surgical emergencies. Traditionally, management of non-traumatic emergency conditions requiring surgery has been entrusted to both general surgeons and surgical subspecialists, depending on the supply and availability of these surgeons in each hospital, but as stated above, many surgeons are reluctant to take on-call responsibilities.

Dr. Matthew Johnson is board-certified in acute care surgery, general surgery, and critical care, as well as being a board-certified robotic surgeon. After completing his residency in general surgery, he then went on to become one of the early fellows in the country to complete an acute care surgery fellowship at the University of Nevada School of Medicine.

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Women & Gallstones

Did you know that women are at increased risk for gallstones

Gallstones occur in up to 20% of American women by the age of 60. Women between the ages of 20 and 60 years are three times more likely to develop gallstones than men.

Risk Factors for Development of Gallstones

  • Multiple pregnancies
  • Family history of gallstones
  • Hispanic or American Indian heritage
  • Obesity
  • Rapid loss of weightgallstones_symptomspic

ASPIRIN MAY HELP WARD OFF GASTRIC CANCERS

DrJohnson

A new study suggests that taking aspirin regularly over several years may help prevent gastrointestinal cancers. The results of the study were presented recently at an American Association for Cancer Research meeting in Philadelphia.

Although results of the study showed a 20% lower risk of cancers of the gastrointestinal tract, especially in the colon and rectum, among people taking aspirin, the lead researcher, Yin Cao, a postdoctoral research fellow at the Harvard School of Public Health in Boston, doesn’t think people should start taking aspirin to prevent cancer until more research is done. In addition, patients and their doctors need to consider the potential risks of taking aspirin, including stomach bleeding. Still, the researcher indicated that the data suggest that along with the benefits of aspirin in the prevention of heart attacks and strokes, long-term regular aspirin use may have even more significant health benefits than known before.

The benefit of aspirin in reducing overall cancer risk appeared to depend on how much one took. The more aspirin taken, the more the risk was reduced. Amounts ranged from less than one aspirin a week to 15 or more, the researchers said. Getting the biggest benefit from aspirin required taking it for at least 16 years. The benefit was no longer seen within four years of stopping it, the researchers found. According to the study authors, the association of aspirin with reduced cancer risk was the same for women and men regardless of race, history of diabetes, family history of cancer, weight, smoking, regular use of other painkillers, or taking multivitamins.

Although aspirin is recommended for most people who have had a heart attack and has some benefits for cancer risk as well, at this point the American Cancer Society does not recommend that people use aspirin specifically to prevent cancer because it is not clear that the benefits with respect to cancer outweigh the risks. While not common, aspirin can cause serious, even occasionally fatal, stomach bleeding, even at low doses.