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- BookScott R. Steele, Justin A. Maykel, Bradley J. Champagne, Guy R. Orangio, editors.Summary: Complexities in Colorectal Surgery: Decision-Making and Management provides a unique, modern, practical guide that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert Colorectal Surgeons caring for patients with complex problems whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The text is formatted as both a "how-to" manual as well as an algorithm-based guide allowing the reader to understand the thought process behind the proposed treatment strategies. By making use of evidence-based recommendations, each chapter will include not only diagnostic and therapeutic guidelines, but also a narrative by the author on his/her operative technical details and perioperative "tips and tricks" that they utilize in the management of these complex surgical challenges. This test includes chapters on the assessment of risk and nutritional intervention methods utilized to minimize perioperative complications. In addition, sections on medical and surgical therapies for abdominal, pelvic and anorectal disease are incorporated. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is to provide pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. The text also goes beyond the technical aspects of Colorectal Surgery and includes special sections highlighting the essence of a surgeon. These include chapters describing the importance of the first encounter, building patient rapport, and demonstrating confidence and competence while showing humility and avoiding arrogance. Additionally, aspects involving the medical-legal, ethical, and economic challenges confronting surgeons are covered.
Contents:
Preoperative
The Abdomen
The Pelvis
Anorectal Disease
Special Situations
Beyond the Operating Room. - ArticleCasterline CL, Evans R, Battista VC, Talamo RC.Chest. 1978 Jun;73(6):885-6.We describe a patient in whom selective IgA deficiency and homozygous alpha1-antitrypsin deficiency were discovered. Clinically, the patient suffered from chronic sinopulmonary infections, destructive emphysema, and bronchiectasis. The interrelation of IgA and alpha1-antitrypsin was studied. Twenty-three alpha1-antitrypsin-deficient sera were screened for IgA deficiency. None of these sera were deficient in IgA. Fifteen IgA-deficient sera were screened for alpha1-antitrypsin deficiency. In this group, three patients were found to have variant alpha1-antitrypsin phenotypes. Respiratory infections were a prominent complaint in all three of these patients, with bronchiectasis in two patients. We believe that the combination of IgA and alpha1-antitrypsin deficiencies should be considered in the evaluation of any patient with idiopathic bronchiectasis.