M Bernstein

..In this paper the authors examine the challenges of defining surgical innovation and briefly review the literature on this challenging subject...

..The ethical dilemmas that residents experience throughout their training have not been explored qualitatively from surgical residents' perspectives...

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..The purpose of this study is to describe and evaluate priority setting in a hospital in response to SARS using the ethical framework 'accountability for reasonableness'...

..A right pterional image-guided craniotomy successfully allowed for drainage of the cyst and resection of the nodule. The pathology was adamantinomatous craniopharyngioma. The patient had an excellent surgical recovery and a good outcome...

..New surgical outreach clinics should be carefully planned. The specialist surgeon must have adequate flexibility and time for this activity and the success of the clinic must be assessed regularly...

..We undertook a study to examine this issue, focusing on two large training programs, one in the developed world and one in the developing world...

..The author contends that both duties can be fulfilled simultaneously, but the surgical tension inherent in this situation must not be ignored or taken for granted...

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..Comprehensive frameworks do not exist for the assessment of bioethical issues pertaining to research on human volunteers...

..The role of residents in surgery is not clearly explained to patients. The authors undertook a study to explore the level of knowledge and anxiety in patients regarding residents' involvement in their surgery...

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..Proper prospective studies including satisfaction surveys would help resolve these issues and will be the next step...

..Its spread to Asia could have significant impact based on the large population of patients and the low resource utilization associated with awake craniotomy...

..Patient selection must be stringent with respect to the patient's preoperative functional status, tumor depth, surrounding edema, patient support at home, and ease of access to hospital for readmission...

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..We have developed a systematic approach to achieve confidence on the geometric integrity of a given imaging system/technique for clinical integration in SRS application...

..The use of remifentanil infusion in conjunction with propofol is a good alternative to fentanyl and propofol for conscious sedation for the awake craniotomy and these techniques are both well accepted by the patient...

..However, individuals' ability to recognise the effects of sleep deprivation has not been studied in medical education. We examined the perceived impact of sleep deprivation among different groups of postgraduate medical trainees...

..This would undoubtedly improve cost-effectiveness for the system while simultaneously improving the patients' quality of life...

..Delayed neurosurgical care comes with a high personal and social cost. By measuring the time from diagnosis to treatment and taking note of institutional practices, changes can be initiated to improve patient waiting times...

..Effective communication is important for reducing medical errors, and perhaps these modifications will facilitate this important endeavor...

..The focus of this review is to highlight recent advances and major innovations in SRS technologies relevant to clinical practice and developments allowing for non-invasive frame SRS...

..This report outlines a novel 11-year experience with outpatient image-guided biopsy and outpatient craniotomy for supratentorial intraaxial brain tumors...

..We report a patient with glioblastoma multiforme who is alive and disease-free 13 years following aggressive treatment with multiple surgeries, radiotherapy, chemotherapy, and gene therapy...

..The level of concern about error varies among patients, but most felt that discussion of error was a good thing...

..The issue of residents operating and disclosure to patients about this have not been explored from staff surgeons' perspectives...

..Current trends in practice patterns in neurosurgery mandate ongoing monitoring of residents' operative experience while ensuring continued excellence in patient care...

..In this study the authors aim was to explore patients' perceptions about awake and outpatient craniotomy...

..The authors report treatment complications from the early experience of 2 Canadian GKS programs in Toronto and Sherbrooke...

..The author briefly reviews the analysis by the JCB group and further examines how bioethical principles and theories relate to the numerous ethical issues raised by SARS and the methods used in its containment...

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..Survival of more than 10 years is extremely rare, especially when identified in 3 out of 71 patients assigned to one arm of a randomized controlled trial...

..The purpose of this discourse is to apply moral philosophical analysis to a delicate but important issue which will be a matter all physicians and surgeons will have to confront, probably numerous times, in their professional careers...

..It can also enhance the focus of our current expectations of HCPs' duty during epidemics. This can be achieved by informing regulatory bodies, collaborating with policy makers and engaging the public...

..The authors prospectively assessed the value of awake craniotomy used nonselectively in patients undergoing resection of supratentorial tumors...

..We have been performing OLM since 1997 (MB) and 2002 (EMM), but no study of patient satisfaction has been carried out to date. the objective of our study was to investigate patient satisfaction with the experience...

..We reviewed the surgical experience of one surgeon to determine the nature and frequency of complications associated with this procedure...

..CONCLUSION: This case illustrates a VAE during an awake craniotomy and emphasizes the importance of early diagnosis in the management...

..Surgical error is common and contributes to complications for patients, necessitating detailed prospective collection and analysis of error data that emphasizes prevention...

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..It is used to treat a variety of well-demarcated intracranial lesions, including brain tumors. This study aims to explore patients' perspectives of the GKSRS process and the various stages involved...

..It screened most Quebec newborns between 1989 and 1994 for neuroblastoma. As previously reported, the screening did not reduce neuroblastoma mortality and caused adverse health effects...

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..Attempts were made to reduce the impact of selection bias by repeating the data analysis after omitting patients with major negative prognostic factors...

..CONCLUSION: Complete monocular blindness due to tumour compressing or distorting the anterior visual pathways does not preclude recovery following timely decompressive surgery, especially when the appearance of the optic disc is normal...

..Some simple recommendations for improving disrespectful behaviour amongst hospital workers are offered...

..9%) is high. Adequate perioperative pain management and effective control of nausea and vomiting may further improve the patients' experience after anesthesia for ambulatory microdiscectomy...

..The results provide insight into how patients approach their identity prior to potentially identity-altering procedures and what future ethical challenges lay ahead for clinicians and researchers in the field of neurotherapeutics...

..CONCLUSIONS: Lumbar microdiscectomy can be performed safely as an outpatient procedure, resulting in a substantial reduction in hospitalization times...

..To the authors' knowledge, this is the first reported case of rapid, nonhemorrhagic expansion associated with necrosis in a previously asymptomatic subependymoma...

..This approach would be expected to result in health care resource and cost savings, with a potential increase in patient satisfaction because of shorter hospital stays...

..Delays in the operating room have a negative effect on its efficiency and the working environment. In this prospective study, we analyzed data on perioperative system delays...

..Ethical criteria, such as the ones proposed here, need to be established now and applied in earnest if the field is to move forward and if patients with no other therapeutic options are to receive much-needed treatment...

..The purpose of this article is to encourage fellow neurosurgeons to pursue this enjoyable and valuable endeavour, to utter a call to arms so to speak...

..Factors predicting neurological outcome would also be helpful for patient selection for surgically based clinical trials...

..Further detailed pharmacokinetic studies of irinotecan in patients receiving concomitant therapy with enzyme-inducing anticonvulsants are required so that rational dosing recommendations can be provided for this patient population...

..Effective chemotherapy is lacking for most types of central nervous system (CNS) tumors in children. Temozolomide, an agent with activity against adult brain tumors, was investigated in children and adolescents with recurrent CNS tumors...

..To determine the maximum-tolerated dose, dose-limiting toxicity (DLT), and pharmacodynamics of the proteasome inhibitor bortezomib (formerly PS-341) in children with recurrent or refractory solid tumors...

..We sought to define the response rate of nelarabine in children and young adults with refractory or recurrent T-cell disease...

..A phase II study was performed to determine the efficacy of irinotecan (IRN) in children with refractory solid tumors. Secondary objectives were to evaluate toxicity, pharmacokinetics, pharmacodynamics, and UGT1A1 genotype...

..v. administration over 1 h. In contrast, the terminal half-life for the active metabolite, 8-oxo-O(6)BG, is 4-fold longer. The pharmacokinetic parameters for O(6)BG and 8-oxo-O(6)BG are similar to those reported previously in adults...

..To determine the maximum tolerated dose and pharmacokinetics of Doxil in children with recurrent or refractory solid tumors. Doxil is pegylated doxorubicin...