Content from the Journal of the American Neurological Surgeons.
A 52-year-old man presented to the emergency department with complaints of hemoptysis for two days (1/2 to 1 cup of bright blood). At the time of admission, the patient reported a two-day history of fever (102o F) and chills, but denied weight loss or night sweats. Patient Presentation A 52-year-old man presented to the emergency…
This video demonstrates an orthotopic heart transplantation.
By Sorin V. Pusca, MD, Barry C. Esrig, MD, Preet M.S. Randhawa, MD, Dusan Knezevic, MD , and Muhamed Saric, MD Patient Presentation A 65-year-old female presented to the emergency department with acute respiratory failure due to pulmonary edema. She had a history of several months of worsening dyspnea on exertion. She was admitted to the intensive…
The vast majority of medical students love their surgical rotation because they get to see inside the magical world of a living body. They finally get to walk through forbidding doors that are labelled with signs that read “Surgical Personnel Only” or “Do Not Enter – Restricted Area.” They see what lies behind this previously…
I have been asked to write an “Opinion Piece” for this section of CTSNet especially addressing my thoughts and philosophy regarding a career in cardiothoracic surgery. After cogitating over this assignment for some time, I felt that I could not improve over the thoughts that I put forth in a letter to my son as…
After Sept 11, 2001, the world rallied around the USA. A common opinion was that the act of terrorism had been defeated by giving the world a cause around which to unite. In spite of the devastation in New York, the situation worldwide looked hopeful in many respects. Today, circumstances are quite different. In only…
Introduction Many successful businesses worry about the quality of the goods and services they produce for a variety of practical and ethical reasons including competition, increased consumer awareness, and fear of government regulation or liability litigation. Industries sensitive to these issues not only expend resources to improve the quality of their output, but they also…
When a student completes medical school and reflects on his or her future, that student must make a critical decision about whether to pursue a career as a primary care physician or a specialist. This decision may not necessarily be permanent, for career changes are often made later. But an early decision may be preferable…
The medical community should be profoundly disappointed, but not surprised, that the recent cloning of a human cell for stem cell research was accomplished in South Korea. Disappointed, because the U.S. is intentionally taking a back seat in a therapeutically vital field of research. Not surprised, because that is the inevitable result of the lack…
While the number of operations performed by our specialty in the USA is diminishing, the number of residents being trained for our specialty remains fairly constant. The supply of cardiothoracic surgeons, in my view, needs to be brought into balance with the demand for our services. In brief, too many cardiothoracic residents are being trained…
In 1995 Hal Urschel, MD, past president of the Society of Thoracic Surgeons, served as the Schuster Visiting Professor at The Brigham and Women’s Hospital and Harvard Medical School. During that visit he delivered Surgical Grand Rounds, and his address was entitled “Let’s Bring the Magic Back”. His remarks were insightful and stimulating, and they…
These are trying times for the specialty of cardiothoracic surgery. The educational process for completion of training is criticized for being too lengthy. The work loads and work hours during the required general and cardiothoracic surgical residencies are excessive and stressful, leaving too little time for formal didactic teaching, individual study, family responsibilities, and recreation. …
Senza soldi is nati non fanno miracoli (without money the saints do not perform miracles) – Old Italian proverb It is our choices, Harry, that show what we truly are, far more than our abilities. – Albus Dumbledore, Headmaster at Hogwarts in Harry Potter and the Chamber of Secrets by JK Rowling. Abstract Access to…
A lot has been said recently on the decreasing quality and rising cost of education. So far it seems that the remedies offered have neither lowered the costs nor have they increased the level of quality. Probably it is time to review our existing system of post-graduate education and to examine some features that were…
We all know the monumental contribution of Alain Carpentier to the understanding of the pathology of the mitral valve, its function and therapeutic implications. There were also a number of surgeons who have expanded on the original idea (Duran, Cosgrove and others) and made contributions in this field. We know today unequivocally the superiority of…
Introduction Thoracic surgery has changed profoundly in the past thirty years, and although many of these changes have enabled us to serve patients better, others, particularly within our business environment, do not bode well for the future of our craft. Caseloads are level or declining, catheter-based technologies are improving, income is down, and public scrutiny…
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