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6. State of gas exchange in recumbent and orthostatic positions and under physical load in healthy persons of varying age, sex and body build

Author

Glezer, G. A, Charyyev, M, and Zilbert, N. L

Subjects
Aerospace Medicine
Abstract

Age effect on gas exchange was studied in the recumbent and orthostatic positions and under physical load. In the case of the older age group and for normal as compared with hypersthenic persons, oxygen consumption during rest and during moderate physical overload diminishes. When the vertical position is assumed oxygen consumption in persons of various age groups is distinctly increased, particularly in the elderly group. There is a reduction in the amount of oxygen consumption, oxygen pulse, recovery coefficient, and work efficiency under moderate overload. In persons over 50, physical labor induces a large oxygen requirement and a sharp rise in the level of lactic acid and the blood's lactate/pyruvate ratio. No distinct difference was noted in the amount of oxygen consumed during rest and during physical overload in men and women of the same physical development and age.

Published
1980

7. Understanding the Use and Perceived Impact of a Medical Podcast: Qualitative Study.

Author

Malecki SL, Quinn KL, Zilbert N, Razak F, Ginsburg S, Verma AA, and Melvin L

Abstract

Background: Although podcasts are increasingly being produced for medical education, their use and perceived impact in informal educational settings are understudied., Objective: This study aimed to explore how and why physicians and medical learners listen to The Rounds Table (TRT), a medical podcast, as well as to determine the podcast's perceived impact on learning and practice., Methods: Web-based podcast analytics were used to collect TRT usage statistics. A total of 17 medical TRT listeners were then identified and interviewed through purposive and convenience sampling, using a semistructured guide and a thematic analysis, until theoretical sufficiency was achieved., Results: The following four themes related to podcast listenership were identified: (1) participants thought that TRT increased efficiency, allowing them to multitask, predominantly using mobile listening platforms; (2) participants listened to the podcast for both education and entertainment, or "edutainment"; (3) participants thought that the podcast helped them keep up to date with medical literature; and (4) participants considered TRT to have an indirect effect on learning and clinical practice by increasing overall knowledge., Conclusions: Our results highlight how a medical podcast, designed for continuing professional development, is often used informally to promote learning. These findings enhance our understanding of how and why listeners engage with a medical podcast, which may be used to inform the development and evaluation of other podcasts., (©Sarah L Malecki, Kieran L Quinn, Nathan Zilbert, Fahad Razak, Shiphra Ginsburg, Amol A Verma, Lindsay Melvin. Originally published in JMIR Medical Education (http://mededu.jmir.org), 19.09.2019.)

Published
2019
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8. Neoadjuvant therapy and major arterial resection for potentially reconstructable arterial involvement by stage 3 adenocarcinoma of the pancreas.

Author

Loveday BPT, Zilbert N, Serrano PE, Tomiyama K, Tremblay A, Fox AM, Segedi M, O'Malley M, Borgida A, Bianco T, Creighton S, Dodd A, Fraser A, Moore M, Kim J, Cleary S, Moulton CA, Greig P, Wei AC, Gallinger S, Dhani N, and McGilvray ID

Subjects
Adolescent, Adult, Aged, Biopsy, Carcinoma, Pancreatic Ductal blood supply, Carcinoma, Pancreatic Ductal diagnosis, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoadjuvant Therapy methods, Pancreatic Neoplasms blood supply, Pancreatic Neoplasms diagnosis, Plastic Surgery Procedures methods, Retrospective Studies, Tomography, X-Ray Computed, Young Adult, Carcinoma, Pancreatic Ductal therapy, Hepatic Artery surgery, Mesenteric Artery, Superior surgery, Neoplasm Staging, Pancreatectomy methods, Pancreatic Neoplasms therapy, Vascular Surgical Procedures methods
Abstract

Background: Stage 3 pancreatic ductal adenocarcinoma (PDAC) is defined by arterial involvement. This study objective was to evaluate outcomes for patients with stage 3 PDAC with potentially reconstructable arterial involvement, considered for neoadjuvant therapy (NAT) and pancreatic resection, and to compare outcomes following arterial (AR) and non-arterial resection (NAR)., Methods: This study included patients from 2009 to 2016 with biopsy-proven stage 3 PDAC who were offered NAT before surgical exploration. AR was performed if required to achieve R0 resection. Time to event outcomes were analysed from diagnosis date., Results: 87/89 patients (97.8%) received NAT (chemotherapy 41.6%, chemotherapy/radiotherapy 56.2%). 46/89 (51.7%) underwent exploration; 31 underwent resection (AR n = 20, NAR n = 11). AR patients had longer operative time (681 vs. 563 min, p = 0.006) and more blood loss (1600 vs. 575 mL, p = 0.0004), with no difference for blood transfusion, pancreatic fistula, length of stay, reoperation, or mortality. R0 rate was 30/31. Post-resection 90-day mortality was 3.2%. Median overall survival was statistically comparable between the AR and NAR groups (19.7 vs. 28.4 months, p = 0.41)., Conclusions: AR had comparable clinical and oncologic outcomes to NAR. Following careful selection and non-progression after NAT, major AR may cautiously be considered if required to obtain a negative resection margin., (Copyright © 2018. Published by Elsevier Ltd.)

Published
2019
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10. Docemur Docemus: Peer-Assisted Learning Improves the Knowledge Gain of Tutors in the Highest Quartile of Achievement but Not Those in the Lowest Quartile.

Author

Donohoe CL, Conneely JB, Zilbert N, Hennessy M, Schofield S, and Reynolds JV

Subjects
Education, Medical, Undergraduate methods, Educational Measurement statistics & numerical data, Peer Group
Abstract

Objectives: Peer-assisted learning (PAL) is a form of collaborative learning where members of a peer group act as teachers for each other. A reciprocal PAL program was designed to investigate whether there were differential gains in knowledge acquisition among tutors compared with tutees., Design: Bayesian statistical analysis was used to quantitatively assess the effect of tutor status on performance in a knowledge-based examination. Subgroup analysis according to student achievement and question difficulty was performed., Participants and Setting: Final year undergraduate medical students in a 5-year degree program (n = 126)., Results: The overall probability of getting a correct answer on the knowledge examination was 49.7%. For questions on topics where a student had acted as a tutor this improved to 57.3%. However, students who performed in the upper quartile had a greater percentage gain in the probability of a correct answer in topics that they had taught vs students who performed in the lowest quartile., Conclusions: There was demonstrable overall knowledge gain associated with acting as a tutor in a PAL program but the greatest gain occurred in students of highest academic ability., (Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2015
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11. Coaching Surgeons: Is Culture Limiting Our Ability to Improve?

Author

Mutabdzic D, Mylopoulos M, Murnaghan ML, Patel P, Zilbert N, Seemann N, Regehr G, and Moulton CA

Subjects
Female, Grounded Theory, Humans, Male, Models, Educational, Operating Rooms, Professional Autonomy, Self Concept, Attitude of Health Personnel ethnology, Education, Medical, Continuing methods, Mentors, Problem-Based Learning methods, Specialties, Surgical education, Surgeons psychology
Abstract

Objective: To explore surgeons' perceptions of and potential concerns about coaching., Background: There is growing recognition that the traditional model of continuing professional development is suboptimal. This has led to increasing interest in alternative strategies that take place within the actual practice environment such as coaching. However, if coaching is to be a successful strategy for continuing professional development, it will need to be accepted by surgeons., Methods: This was a qualitative interview-based study using a constructivist grounded theory approach. Participants included 14 surgeons from University of Toronto-affiliated hospitals., Results: Participants expressed 3 main concerns about coaching: questioning the value of technical improvement ("As you get older if you don't have the stimulation from surgery to get better or to do things that are different and you are so good at so much, why bother [with coaching]?" P009), worry about appearing incompetent ("I think it would be perceived as either a sign of weakness or a sign of inability" P532), and concern about losing autonomy ("To me that would be real coaching where it's self-identified, I'm motivated, I find the person and then they coach me" P086)., Conclusions and Relevance: Coaching faces unique challenges in the context of a powerful surgical culture that values the portrayal of competency and instills the value of surgical autonomy. This study suggests that hanging on to these tightly held values of competency and autonomy is actually limiting the ways, and extent to which, surgeons can improve their practice.

Published
2015
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12. Canadian Surgery Forum.

Author

Fayez R, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, AlMuntashery A, Fayez R, Demyttenaere S, Christou N, Court O, Bodie G, Bonrath E, Hagen J, Okrainec A, Sullivan P, Grantcharov T, Almamar A, Sharma A, Karmali S, Birch DW, Gill RS, Majumdar SR, Wang X, Tuepah R, Klarenbach SW, Birch DW, Karmali S, Sharma AM, Padwal RJ, Raîche I, Smith C, Haggar F, Moloo H, Poulin EC, Martel G, Yelle JD, Mamazza J, Mueller CL, Jackson TD, Penner T, Pitzul K, Urbach DR, Okrainec A, AlMuntashery A, Villeneuve S, Roy M, Fayez R, Demyttenaere S, Christou N, Court O, Fayez R, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, AlMuntashery A, Fayez R, Demyttenaere S, Court O, Christou N, Moustarah F, Biertho L, Hould FS, Lebel S, Lescelleur O, Marceau S, Marceau P, Biron S, Khokhotva M, Grantcharov T, Anvari M, Sharma A, Yusuf S, Kwong J, Okrainec A, Pitzul KB, Urbach DR, Jackson T, Elkassem S, Lindsay D, Sullivan P, Smith L, Bonrath E, Zevin B, Dedy N, Grantcharov TP, Zevin B, Bonrath EM, Aggarwal R, Grantcharov T, Sockalingam S, Cassin S, Crawford S, Pitzul K, Khan A, Hawa R, Jackson T, Okrainec A, Smith C, Brar B, Mamazza J, Raîche I, Yelle JD, Haggar F, Moloo H, Smith C, Brar B, Haggar F, Dent R, Mamazza J, Raîche I, Moloo H, Whitlock KA, Gill RS, Ali T, Shi X, Birch DW, Karmali S, Gill RS, Whitlock KA, Shi X, Sarkhosh K, Birch DW, Karmali S, Suri M, Turner JM, Nation PN, Wizzard P, Brubaker PL, Gisalet DL, Wales PW, Palter VN, Grantcharov TP, Wakeam E, Tien H, Spencer F, Brenneman F, Khan RSA, Kowal J, Wiseman SM, Martelli V, Fraser SA, Vedel I, Deban M, Holcroft C, Monette M, Monette J, Bergman S, Malik A, Bell C, Stukel T, Urbach DR, Young PY, Mueller TF, Lucykx VA, Lukowski CM, Compston CA, Churchill TA, Khadaroo RG, Daigle C, Grantcharov T, McCreery G, Vogt K, Dubois L, Gray D, Seth R, Ananth A, Tai LH, Lam T, Falls T, Souza C, Bell J, Auer R, Paskar D, Crawford S, Parry N, Leslie K, Sudarshan M, Alhabboubi M, St-Louis E, Deckelbaum D, Razek T, Feldman LS, Khwaja K, Richardson D, Porter G, Johnson P, Haggar F, Boushey R, Moloo H, Raiche I, Mamazza J, Davis VW, Schiller DE, Eurich D, Sawyer MB, Rivard J, Vergis A, Unger B, Hardy K, Andrew C, Gillman L, Park J, Agzarian J, Prodger J, Kelly W, Kelly S, Prodger D, Racz J, Ewara E, Martin J, Sarma S, Chu M, Schlachta C, Zaric G, Winocour J, Al-Ali K, Briggs K, George R, Zilbert NR, Murnaghan ML, Leung A, Regehr G, Moulton CA, Decker C, Neumann K, Mahmud S, Metcalfe J, McKay A, Park J, Hochman D, Gosney JE Jr, Burkle FM Jr, Redmond AD, McQueen K, Wissanji H, Desrosiers E, Gilbert A, Chadi SA, Leslie K, Ott MC, Alhabboubi M, Sudarshan M, Jessula S, Alburakan A, Deckelbaum D, Razek T, Iqbal S, Khwaja K, Partridge E, Aikins C, Alhabboubi M, Sudarshan M, Deckelbaum D, Iqbal S, Khwaja K, Razek T, Olszewski M, Roberts N, Moulton CA, Murnaghan ML, Cil T, Chan R, Marshall J, Pederson K, Erichsen S, White J, Nadler A, Aarts MA, Okrainec A, Victor JC, Pearsall E, McLeod RS, Hameed U, Jackson TD, Okrainec A, Penner TP, Urbach DR, Brotherhood H, Karimuddin A, Hall C, Bawan S, Malik S, Hayashi A, Menezes AS, Gill RS, McAlister C, Zhang N, DesRosiers E, Mills A, Crozier M, Lee L, Maxwell J, Partridge E, Chad S, Steigerwald S, Mapiour D, Roberts D, MacPherson C, Donahoe L, MacDonald B, Mercer D, Hopman W, Rakovich G, Latulippe JF, Hilsden R, Knowles S, Moffat B, Parry N, Leslie K, Merani S, Switzer N, Khadaroo RG, Tul Y, Widder S, Davis P, Molinari M, Levy A, Johnson P, Davis PJB, Bailey J, Molinari M, Hayden J, Johnson P, Cools-Lartigue J, Benlolo S, Marcus V, Ferri L, Ojah J, Finley R, Anderson D, Julien F, Gagné JP, Carter D, Chan S, Wong S, Li J, Michael A, Choi D, Liu E, Hoogenes J, Dath D, Pitt D, Aubin JM, Banks BA, Mew D, McConnell Y, Rudovics A, Classen D, Kanthan S, Ravichandran P, Croome KP, Kovacs MJ, Lazo-Langner A, Hernandez-Alejandro R, Anantha R, Vogt K, Crawford S, Parry N, Leslie K, Aad I, Kholdebarin R, Khoshgoo N, Iwasiow BM, Keijzer R, Aird LNF, Brown CJ, Wong SL, Isa D, Pace D, Payne JRM, Widder S, Tul Y, Primrose M, Hudson D, Khadaroo RG, Hallet J, Lauzier F, Mailloux O, Trottier V, ARchambault P, Zarychanski R, Turgeon AF, Mailloux O, Farries L, Hardy P, Muirhead RM, Raiche I, Masters J, Haggar F, Poulin HMEC, Martel G, Mamazza J, Botkin C, Milbrandt C, Keijzer R, Morency D, Sideris L, Grenier-Vallée P, Latulippe JF, Dubé P, Berger-Richardson D, Kurashima Y, Kaneva P, Feldman LS, Fried GM, Vassiliou MC, Isa AD, Kwan AH, Dupuis I, Fraser SA, Schweigert M, Solymosi N, Rauh N, Dubecz A, Renz M, Ofner D, Stein HJ, Koubi S, Borgaonkar M, Ernjakovic M, Crystal P, Easson A, Escallon J, Reedijk M, Cil T, Leong WL, McCready DR, Grant K, Clifton J, Mayo J, Finley R, Cools-Lartigue J, Noreau-Nguyen M, Mulder DS, Ferri LE, Carrott P, Markar S, Hong J, Low DE, Stafford T, Maslow A, Davignon K, Ng T, Malthaner R, Tan L, Aruranian J, Kosa S, Sudarshan M, Ferri LE, Hanna WC, Murphy G, Allison F, Moshonov H, Darling GE, Waddell TK, De Perrot M, Cypel M, Yasufuku K, Keshavjee S, Paul NS, Pierre AF, Lee L, Darling G, Pedneault C, Marcus V, Mulder DS, Ferri LE, Markar S, Low D, Razzak R, Roa W, Löbenberg R, McEwan S, Bédard EL, Bharadwaj SC, Louie BE, Farivar AS, McHugh SP, Aye RW, Ashrafi AS, Tan-Tam C, De Vera M, Bond RJ, Ong SR, Johal B, Schellenberg D, Po M, Nissar S, Lund C, Ahmadi SY, Ouellette D, Wakil N, Rakovich G, Beauchamps G, Markar S, Preston S, Baker C, Low D, Bottoni DA, Campbell G, Malthaner RA, Knickle C, Bethune D, Henteleff H, Johnston M, Buduhan G, Coughlin S, Coughlin HE, Roth L, Bhandari M, Malthaner R, Gazala S, Johnson J, Kutsogiannis J, Bédard E, Gazala S, Rammohan K, Stewart K, Bédard E, Donahoe L, Buduhan G, Walker K, Gruchy J, Xu Z, Buduhan G, Li C, Ferri LE, Mulder DS, Ncuti A, Neville A, Kaneva P, Watson D, Vassiliou M, Carli F, Feldman LS, Alnasser S, Av R, Mayrand S, Franco E, Ferri LE, Schweigert M, Dubecz A, Renz M, Stadlhuber RJ, Ofner D, Stein HJ, Schweigert M, Renz M, Dubecz A, Solymosi N, Thumfart L, Ofner D, Stein HJ, Zhuruk A, Croome K, Leeper R, Hernandez R, Hanouf A, Livingstone S, Sapp J, Woodhall D, Alwayn I, Vanounou T, Bergman S, Karanicolas P, Lam-McCulloch J, Balaa F, Jayaraman S, Quan D, Wei A, Guyatt G, Aubin JM, Rekman JF, Fairfull-Smith RJ, Mimeault R, Balaa FK, Martel G, Yeung JC, Boehnert MS, Bazerbachi F, Knaak JM, Selzner N, McGilvray ID, Rotstein OD, Adeyi OA, Levy GA, Keshavjee S, Grant DR, Selzner M, Dumitra S, Khalil JA, Jamal M, Chaudhury P, Zogopoulos G, Petrakos P, Tchervenkov J, Barkun J, Simoneau E, Jamal MH, Hassanain M, Chaudhury P, Wong S, Salman A, Tran T, Metrakos P, Vanounou TT, Groeschl RT, Geller DA, Marsh JW, Gamblin TC, Howe B, Croome K, Hawel J, Croome K, Quan D, Hernandez R, Jang JH, Kim PTW, Greig PD, Gallinger S, Moulton CA, Wei AC, Fischer SE, Cleary SP, Bertens K, Vogt KN, Hernandez-Alejandro R, Gray DK, Rekman JF, Aubin JM, Fairfull-Smith JJ, Mimeault R, Balaa FK, Martel G, Wei AC, Devitt KS, Ramjaun A, Gallingher S, Dumitra S, Alabbad S, Constantinos D, Hassanein M, Barkun J, Metrakos P, Paraskevas S, Chaudhury P, Tchervenkov J, Koubi S, Borgaonkar M, Ouellet JF, Tanyingoh D, Dixon E, Kaplan GG, Myers RP, Howard TJ, Sutherland FR, Zyromski NJ, Ball CG, Wei AC, Coburn N, Moulton CA, Cleary SP, Law CH, Greig P, Steven G, Covelli A, Baxter N, Fitch M, Wright F, Maniar R, Hochman DJ, Wirtzfeld DA, McKay A, Yaffe CS, Yip B, Silverman R, Park J, Sun S, McConnell YJ, Temple WJ, Mack LA, Davis VW, Schiller DE, Bathe OF, Sawyer MB, Brackstone M, Scott L, Vandenberg T, Perera F, Potvin K, Chambers A, Boissonneault R, Loungnarath R, DeBroux É, Lavertu S, Donath D, Ayoub JP, Tehfé M, Richard C, Kim SHH, Cornacchi SD, Heller B, Farrokhyar F, Babra M, Lovrics PJ, Baliski C, Liberto C, Gazala S, Ghosh S, McLean R, Schiller D, Hameed U, Jackson TD, Okrainec A, Penner TP, Urbach DR, Sudarshan M, Dumitra S, Duplisea J, Wexler S, Arnaout A, Seely J, Smylie J, Knight K, Robertson S, Watters J, Wedman D, Zhang T, Arneout A, Nostedt M, Hochman D, Wirtzfeld D, McKay A, Yip B, Yaffe CS, Silverman R, Park J, Hebbard P, Baxter N, Yun L, Rakovitch E, Wright F, Warner E, McCready D, Hodgson N, Quan ML, Shetty SJ, Natarajan B, Govindarajan V, Thomas P, Loggie BW, Dixon M, Brar S, Mahar A, Law C, Coburn N, Wei AC, Devitt KS, Wiebe M, Bathe OF, McLeod RS, Baxter NN, Gagliardi AR, Kennedy ED, Urbach DR, Dixon M, Brar S, Mahar A, Law C, Coburn N, Kazazian K, Zih F, Rosario C, Dennis J, Gingras AC, Swallow C, Lemke M, Ko YJ, Rowsell C, Law CHL, Wells B, Saskin R, Quan ML, Musselman RP, Xie M, McLaughlin K, Marginean C, Moyana TN, Moloo H, Boushey RP, Auer RC, Zih FSW, Razik R, Haase E, Mathieson A, Smith AJ, Swallow CJ, Menezes AS, Barnes A, Scheer AS, Moloo H, Boushey RP, Sabri E, Auer RAC, Nassif M, Reidel K, Trabulsi N, Meterissian S, Tamblyn R, Mayo N, Meguerditchian AN, Leon-Carlyle M, Brown JA, Hamm J, Phang PT, Raval MJ, Brown CJ, Wei AC, Devitt KS, Wiebe M, Bathe OF, McLeod RS, Taylor B, Urbach DR, Krotneva S, Reidel K, Mayo N, Tamblyn R, Meguerditchian A, Bradley NL, Hamm JD, Wiseman SM, Trabulsi N, Patakfalvi L, Nassif M, Turcotte R, Nichols A, Meguerditchian A, Trabulsi N, Riedel KE, Winslade NE, Grégoire JP, Meterissian S, Abrahamovicz M, Megueerditchian A, Chin-Lenn L, Pasieka J, Cheng H, McMillan C, Lipa J, Snell L, Petrucci AM, Sudarshan M, Dumitra S, Duplisea J, Wexler S, Meterissian S, Sandhu L, Tomlinson G, Kennedy ED, Wei A, Baxter NN, Urbach DR, Neville A, Liberman AS, Charlebois P, Stein B, Ncuti A, Vassiliou MC, Fried GM, Feldman LS, Lee L, Capretti G, Power A, Liberman AS, Charlebois P, Stein B, Kaneva P, Carli F, Fried GM, Feldman LS, Li C, Carli F, Charlebois P, Stein B, Liberman AS, Kaneva P, Augustin B, Gamsa A, Kim DJ, Vassiliou M, Feldman L, Yang I, Boushey R, Moloo H, Prabhu KL, Vu L, Chan S, Phang PT, Gown A, Jones S, Wiseman S, Melich G, Jeong DH, Hur H, Baik SH, Kim NK, Faria J, Min BS, Knowles S, Lumb K, Colquhoun P, Richardson D, Porter G, Johnson P, Borowiec AM, Baxter NN, Schmocker S, Huang H, Victor JC, Krzyzanowska MK, Brierley J, McLeod RS, Kennedy ED, Hallet J, Milot H, Desrosiers E, Lebrun A, Drolet S, Bouchard A, Grégoire RC, Boissonneault R, Vuong T, Loungnarath R, DeBroux E, Liberman AS, Charlebois P, Stein B, Richard C, Kolozsvari NO, Capretti G, Kaneva P, Neville A, Carli F, Liberman S, Charlebois P, Stein B, Vassiliou MC, Fried GM, Feldman LS, Hallet J, Milot H, Drolet S, Bouchard A, Grégoire RC, Tuttle P, Powell R, Fowler A, Mathieson A, VanHouwelingen L, Martin K, Vogt K, Ott MC, Haggar F, Pereira G, Einarsdottir K, Moloo H, Boushey R, Mamazza J, Boulanger-Gobeil C, Bouchard A, Gagné JP, Grégoire RC, Thibault C, Bouchard P, Chan BP, Gomes T, Musselman RP, Auer RC, Moloo H, Mamdani M, Al-Omran M, Boushey RP, AlObeed O, Chan BP, Armstrong JBP, Fergusson DA, Forster AJ, Boushey RP, Richardson D, Porter G, Johnson P, Musselman RP, Gomes T, Chan BP, Auer RC, Moloo H, Mamdani M, Al-Omran M, Al-Obaid O, Boushey RP, Melich G, Lim DR, Min BS, Baik SH, Gordon PH, Kim NK, Phang PT, Lo A, Pinsk I, Brown C, Raval M, Goldstein LJ, Cheng H, Wen C, Wong C, Johnston N, Farrokhyar F, Stephen W, Kelly S, Lindsay L, Forbes S, Lebrun A, Bouchard A, Chadi SA, Parry NG, Leslie K, and Ott MC

Published
2012
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13. A large struma ovarii tumor removed via laparoscopy in a 16-year-old adolescent.

Author

Ezon I, Zilbert N, Pinkney L, Wei JJ, Malik R, and Nadler EP

Subjects
Adolescent, Female, Humans, Laparoscopy, Ovarian Neoplasms surgery, Ovariectomy methods, Struma Ovarii surgery
Abstract

Struma ovarii is rare ovarian tumor that is characterized by the presence of at least 50% thyroid tissue on histologic examination. This usually benign neoplasm is predominantly found in women between the ages of 40 and 60 years and infrequently in the pediatric age group. In the foregoing report, we present an unusual case of a large struma ovarii in a 16-year-old adolescent girl with abdominal pain and increasing abdominal girth. Removal of the mass was achieved via a laparoscopic approach. We conclude that the diagnosis of struma ovarii should be considered in adolescent girls presenting with large cystic ovarian masses and that a laparoscopic approach to management is the treatment of choice.

Published
2007
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14. Effects of propranolol on haemodynamic changes and gas exchange at rest, in orthostasis, and on exercise in patients with arterial hypertension.

Author

Glezer GA, Moskalenko NP, Megrelishvili RI, and Zilbert NL

Subjects
Blood Volume, Hematocrit, Humans, Hypertension blood, Oxygen blood, Physical Exertion, Posture, Rest, Hemodynamics drug effects, Hypertension physiopathology, Propranolol pharmacology
Abstract

The effects of propranolol on the circulation and respiration were studied in 38 patients with essential hypertension and symptomatic renal hypertension. The hypotensive effect of propranolol was associated with decrease in the cardiac index and heart rate; the peripheral vascular resistance moderately increased, and the circulating blood volume and haematocrit value showed no essential changes. Besides, a prolongation of the pre-ejection period, the decrease of intrasystolic index, an increase in the myocardial wall-tension index, and a retardation of the elevation rate of the intraventricular pressure were observed. After propranolol medication, on transition into the vertical position the heart rate showed a less marked acceleration; the remaining haemodynamic parameters changed in orthostasis as they had done before the treatment. After propranolol medication, on exercise the systolic and mean arterial pressures, heart rate, and cardiac output exhibited lesser increases than before the treatment, whereas the circulating blood volume, diasolic pressure, and peripheral vascular resistance increased just as they had done before the treatment. At rest, during propranolol medication there appeared a certain tendency to decreased oxygen uptake; in orthostasis the degree of increase in oxygen uptake did not change by the action of propranolol. Besides, propranolol did not alter the blood-plasma levels of lactic acid and pyruvate at rest and did not essentially change the oxygen uptake during exercise. The level of lactic acid and the lactate/pyruvate quotient in plasma during exercise increased slightly less after than without propranolol.

Published
1976

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