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This volume introduces the reader to the most important standards and principles of prophylactic surgery. After discussing the comparative effectiveness of screening in the treatment of hereditary cancer syndromes and evaluating genetic predisposition, the book moves on to address ethical, legal, social and cost-effectiveness dimensions of prophylactic surgery. With the aim of preventing hereditary predisposition syndromes, it also includes a chapter on the application of preventive surgery to all specific fields of surgery. Given its scope, the book will appeal to a broad readership, from experienced surgeons to students.
This sensitive true story of preventive mastectomy and implant breast reconstruction, as written by Heather Barnard in Why is Mommy Having Surgery, will hopefully encourage families to explore their feelings, understand the process, and open the communication to what can be a difficult subject. This book helps children understand what having BRCA means, why mommy is choosing to have preventive surgery and what that process will entail. With a forward written by Dr. Chrysopoulo, breast reconstruction microsurgeon , we hope this book will become a valuable resource for the many women with BRCA looking into preventive measures.
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US $10 billion per year. No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines. These new WHO guidelines are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
After learning that she inherited a BRCA2 genetic mutation that put her at high risk for breast and ovarian cancer, Kim Horner’s doctors urged her to consider having a double mastectomy. But how do you decide whether to have a surgery to remove your breasts to reduce your risk for a disease you don’t have and may never get? Horner shares her struggle to answer that question in Probably Someday Cancer. The mother of a one-year-old boy, she wanted to do whatever would give her the best odds of being around for her son and protect her from breast cancer, which killed her grandmother and great-grandmother in their 40s. Which would give her the best chance at a long healthy life: a double mastectomy or frequent screenings to try to catch any cancer early? The answers weren’t that simple. Based on extensive research, interviews, and personal experience, Horner writes about how and why she ultimately opted for a double mastectomy—the same decision actress Angelina Jolie made for a similar genetic mutation—and the surprising diagnosis that followed. The book explores difficult truths that get overshadowed by upbeat messages about early detection and survivorship—the fact that screenings can miss cancers and that even early-stage breast cancers can spread and become fatal. Probably Someday Cancer is about the author’s efforts to push past her fear and anxiety. This book can help anyone facing hereditary risk of breast and ovarian cancer feel less alone and make informed decisions to protect their health and end the devastation that hereditary cancer has caused for generations in so many families.
Completely revised and updated, and now in full color throughout, the Fourth Edition of this definitive reference is a must for all clinicians who treat breast diseases. Leading experts summarize the current knowledge of breast diseases, including their clinical features, management, underlying biologies, and epidemiologies. In addition to complete coverage of malignant breast diseases, benign diseases are discussed in relation to subsequent breast cancer development. The book reviews all major clinical trials and summarizes the information they provide on early detection and management of breast cancer. Close attention is also given to the increasing importance of molecular biology and genetics in this field. This edition features more than thirty new contributors, fourteen new or completely rewritten chapters, and more clinically oriented chapters. A companion Website will offer the fully searchable text and an image bank. Also included with this edition is the Anatomical Chart Company's Breast Anatomy and Disorders Pocket Guide. This durable, portable folding pocket guide provides a visual and textual overview of breast anatomy, disorders, and breast self-examination. With a write-on, wipe-off laminated surface, this guide is perfect for the on-the-go practitioner to show patients, caregivers, and families.
For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill.The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be-- a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine in America today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.
"Oncoplastic and Reconstructive Surgery for Breast Cancer" describes the reconstructive techniques that have been refined over the past decade by surgeons in a very high volume unit. It provides clear descriptions of all the available techniques. With proven experience in the procedures described and detailed scientific evaluation, it furthermore provides evidence-based literature reviews. The book starts with the relevant anatomical background and passes through all the major oncoplastic and reconstructive procedures available to the breast cancer patient. It includes management of breast and nipple-areolar complex reconstruction in addition to symmetrising surgery and the new technique of fat transfer. It also covers all multidisciplinary aspects and genetics thus giving an up-to-date status report.
Infections that occur in the wound created by an invasive surgical procedure are generally referred to as surgical site infections (SSIs). SSIs are one of the most important causes of healthcare-associated infections (HCAIs). A prevalence survey undertaken in 2006 suggested that approximately 8% of patients in hospital in the UK have an HCAI. SSIs accounted for 14% of these infections and nearly 5% of patients who had undergone a surgical procedure were found to have developed an SSI. However, prevalence studies tend to underestimate SSI because many of these infections occur after the patient has been discharged from hospital. SSIs are associated with considerable morbidity and it has been reported that over one-third of postoperative deaths are related, at least in part, to SSI. However, it is important to recognise that SSIs can range from a relatively trivial wound discharge with no other complications to a life-threatening condition. Other clinical outcomes of SSIs include poor scars that are cosmetically unacceptable, such as those that are spreading, hypertrophic or keloid, persistent pain and itching, restriction of movement, particularly when over joints, and a significant impact on emotional wellbeing. SSI can double the length of time a patient stays in hospital and thereby increase the costs of health care. Additional costs attributable to SSI of between £814 and £6626 have been reported depending on the type of surgery and the severity of the infection. The main additional costs are related to re-operation, extra nursing care and interventions, and drug treatment costs. The indirect costs, due to loss of productivity, patient dissatisfaction and litigation, and reduced quality of life, have been studied less extensively.