Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Gardner syndrome: Clinical and epidemiologic up to date [Attualità cliniche nella sindrome di Gardner: Contributo casistico]

In 1950 EJ Gardner first described a new syndrome characterized by 1) familial colonic polyposis, 2) multiple osteomas, 3) soft tissues cysts and 41 fibrous lesions. Thereafter, in 1975 Watne and coll. have demonstrated the occurence, in patients affected by Gardner syndrome, of the early onset of osteomas and dental inclusions in maxillary bones. Gardner syndrome is actually considered a severe life treathening condition due to the poor quality of life and the evolutive pattern of colonic polyps to colon cancer in 100% of cases. The aim of this paper is the review of the pathophysiologic and clinical aspects of Gardner syndrome, with report of institutional clinical data about epidemiology and clinical presentation of such condition, attempting to elaborate a clinical protocol for early detection of that

Analisi statistica su macro metastasi linfonodali dopo biopsia del linfo nodo sentinella nel trattamento chi rurgico del carcinoma mammario

Questo articolo ha analizzato eventuali variabili che potrebbero essere prese in considerazione nella linfoadenectomia ascellare dopo biopsia positiva del linfonodo nel trattamento del carcinoma mammario. Gli autori hanno voluto verifi care se nelle pazienti da sottoporre a trattamento chirurgico con un solo linfonodo sentinella positivo (LNS +) macrometastatico (con numero di copie di mRNA di citocheratina-19>5000),valutato con metodiche biomolecolari OSNA (one step nucleic acid amplification), si possano individuare caratteristiche in grado di far prevedere l’eventuale negatività dei restanti linfonodi che verrebbero rimossi attra verso l’asportazione ascellare in modo da poter evitare un overtreatment e le possibili conseguenze che ciò comporterebbe. I risultati derivanti dal presente studio suggeriscono a loro volta di valutare un nuovo cut-off del numero di copie di mRNA (RNA messaggero) di citocheratina-19 nel linfonodo sentinella utile per personalizzare i trattamenti chirurgici ed evitare di sottoporre le pazienti con un solo linfonodo metastatico a dissezioni ascellari non necessarie

Il carcinoma mammario in donne anziane e in donne giovani

L'articolo analizza i dati da carcinoma mammario al fine di verificare quali variabili sono maggiormente influenti sull'evoluzione delle dimensioni e della gravità dei noduli. Le analisi statistiche di dipendenza in tabelle due per due e di analisi multivariata hanno evidenziato una forte relazione fra particolari variabili e la gravità della malatti