Tag Archives | surgery

Research During Residency for Oral Surgeons?

Earlier this year over the summer an article appeared in the Journal of Oral and Maxillofacial Surgery discussing the attitudes of program directors and residents toward performing research during residency. I commented on this article here http://blog.teethremoval.com/the-lack-of-importance-of-research-in-oral-and-maxillofacial-surgery-residency-programs/ A new article has appeared in the Journal of Oral and Maxillofacial Surgery written by Dr. James R. Hupp titled Research During Residency – Should it be Mandated? (vol. 69, pages 2685-2687, 2011). In the article is a discussion of research and whether or not it should be performed by oral surgeons in residency. Dr. Hupp discuses his own experience with research work and then questions if the current accreditation standards require all Oral and Maxillofacial Surgery residents to do research. He says: “Now the question becomes, should our standards require all residents to have the opportunity to conduct research and, in my mind, also to learn how to communicate the findings of their research. This is indisputably important for residents planning an academic career. However, how does conducting research during training benefit a resident planning to enter private or institutional clinical practice? Perhaps many more residents should be exposed to research which, ultimately, might lead them to pursue an academic career.” Dr. Hupp […]

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Tips to Prevent Medical Errors – AHRQ

The largely ineffective Agency for Healthcare Research and Quality (AHRQ) has a list of 20 Tips to Help Prevent Medical Errors  http://www.ahrq.gov/consumer/20tips.htm Number 20 on the list is  “Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources.” It then suggests to ask your doctor if the treatment is based on the latest evidence. The way this is presented it seems to say that doctors and nurses often do not always present treatment options based on the latest evidence. As argued by Shannon Brownlee, http://www.washingtonmonthly.com/features/2007/0710.brownlee.html the U.S. is clearly in need of an “… independant agency that would fund systematic reviews of the medical literature, as well as clinical trials to test the comparative effectiveness of everything from drugs to treatments” Unfortunately the current AHRQ is not performing this service as it was rendered somewhat ineffective thanks to Newt Gingrich and Congress in 1996 over the issue of spinal fusion surgery. The Agency for Health Care Policy and Research (AHCPR) was created in 1989 to produce evidence-based, clinical-practice guidelines. What ended up happening was the AHCPR panel concluded that there was little evidence to support surgery as a first line treatment for low back […]

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Surgical Treatment of Migraine Headaches

A study published in Plastic and Reconstructive Surgery shows that trigger site surgery may aid in reducing or even eliminating migraine headaches. 100 patients in a study underwent injection of botulinum toxin A (Botox) into up to 4 potential trigger sites. If a trigger site was identified to be effective than surgery was performed in that trigger area in order to decompress nerves and remove muscles. 71 of 79 patients that were evaluated over a 5 year period were observed to have improvement. This meant they had less mean migraine intensity and or less mean migraine duration. 20 of 69 patients (29.0%) reported elimination of migraines and 41 of 69 patients (59.4%) experience a significant decrease. Surgery is not without risk and neither is injection of botulinum toxin A.  2 patients had hypersensitivity, 2 patients had hyposensitivity, and 2 patients had numbess at their 5 year follow up. This complications occured in the front region. 1 patient had occasional neck stiffness and 2 patients had occasional neck weakness which occurred in the occipital region. I know from firsthand experience after having an occipital nerve block in attempt to end my 24/7 headache brought on by removing my wisdom teeth that […]

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Adverse Sedation Events and Impact on Provider Specialty in Pediatrics

Recently an article was published in Pediatrics titled Impact of Provider Specialty on Pediatric Procedural Sedation Complication Rates with authors Kevin G. Couloures, Michael Beach, Joseph P. Cravero, Kimberly K. Monroe and James H. Hertzog.   (2011, 127, pages e1154-e1160).  The conclusion presented in the abstract of the article is “In our sedation services consortium, pediatric procedural sedation performed outside the operating room is unlikely to yield serious adverse outcomes. Within this framework, no differences were evident in either the adjusted or unadjusted rates of major complications among different pediatric specialists.” The authors mentioned in this article another study conducted in Pediatrics which found over a 27 year period there were 60 cases identified in which death or severe neurological injury occurred of children 0.08 years to 20 years old. However, this study presented different conclusions in the abstract of the study (Adverse Sedation Events in Pediatrics: A Critical Incident Analysis of Contributing Factors with authors Charles J. Cote, Daniel A. Notterman Helen W. Karl, Joseph A. Weinberg, and Carolyn McCloskey – 2000, 105, pages 805-814). “There were differences in outcomes for venue: adverse outcomes (permanent neurologic injury or death) occurred more frequently in a nonhospital-based facility, whereas successful outcomes (prolonged […]

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Oral Surgeon Websites: Similar Content

I wanted to alert everyone to a new article I just wrote and updated on my website http://www.teethremoval.com/oral_surgery_websites_similar_content_similar_sites.html. It talks about how oral surgeons are using PBHS Inc. to design them websites. However, PBHS Inc. uses a template for the websites so the content for all of the websites designed is very similar. This means the information on procedures and even after care procedures for a large number of oral surgeon and oral surgeon group’s websites are nearly exactly the same if not identical. This is quite alarming to me and you should be aware of this if you are considering wisdom teeth removal surgery. The likely explanation is that oral surgeons are not skilled in website design and are not taking the time to modify the content provided by PBHS Inc. Even so, PBHS Inc. has a very large number of oral surgeons in the U.S. who they have developed websites for and are making quite a nice amount of money.

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