OAR@UM Community:

Telling patients the truth

Sat, 01 Jan 2005 00:00:00 GMT

Title: Telling patients the truth Authors: Soler, Denis Abstract: 'And you shall know the truth, and the truth shall make you free' (John 8:32) One of the dilemmas that any practitioner attending a seriously sick/ terminally ill patient experiences is whether he should tell the patient all the truth about the seriousness of his illness or not.

Evaluating a trainee’s progress in surgical dexterity

Sat, 01 Jan 2005 00:00:00 GMT

Title: Evaluating a trainee’s progress in surgical dexterity Authors: Manche, Alexander Abstract: The local cardiac surgical training program is modelled on a one-to-one apprenticeship encompassing a number of years. Trainee progress is regularly audited and work of increasing complexity is provided, commensurate with the trainee's ability. Speed and accuracy are desirable surgical goals and reflect a high level of decision-making and dexterity. The trainee's surgical speed over a period of time was monitored as one measure of progress. The mean time required to complete a coronary anastomosis (graft time) decreased from 12.8±1.9minutes in the first year of training to 9.0±1.9minutes in year four, inter-group variance (ANOVA) was highly significant from year two to year three and from year three to year four (p<0.001). Risk stratification was utilised in the selection of patients for the trainee. Parsonnet score increased from 5.1±3.5 in year one to 6.0±5.0 in year four. Similarly, EuroSCORE increased from 2.1±1.8 to 2.4±2.1. Additionally, variable life-adjusted display (VLAD) plots were constructed in order to provide a visual representation of performance against predicted outcome by EuroSCORE. Successive VLAD plots demonstrate the changing practice of the trainee as it came to resemble more closely that of his instructor and this was achieved without jeopardising patient outcome.

Foot pain

Sat, 01 Jan 2005 00:00:00 GMT

Title: Foot pain Authors: Formosa, Aaron Abstract: Foot complaints are very common in general practice and their incidence increases with age. Three out of four people complain of foot pain during the course of a lifetime, while approximately 20% of people aged 65 years or older complain of non-traumatic foot problems.

Bone graft stabilisation with an osseointegrated implant retained prosthesis

Sat, 01 Jan 2005 00:00:00 GMT

Title: Bone graft stabilisation with an osseointegrated implant retained prosthesis Authors: Camilleri, Simon; Diacono, Mark Abstract: The intricacies of cleft lip and palate treatment are numerous. A case is reported where a problematic alveolar bone graft was finally stabilized by loading the bone with an osseointegrated implant-retained prosthesis. The reasons for failure of the previous grafts are discussed and the importance of a team approach to patient care highlighted.