Anatomical teaching has been centred around dissection for centuries. Generations of doctors have been initiated into the medical profession by cutting into their first cadavers. With the number of donor cadavers available decreasing and medical student numbers increasing, the emphasis placed on dissection has changed dramatically over the past 15 years. However, a solid appreciation of human anatomy is still a necessary part of understanding pathology and treatments. Therefore in light of these changes we ask, is dissection the only option? Or are there other options which students can undertake to develop anatomical knowledge?
There is a paucity of published literature on the use of drains following spinal surgery. This is the first study to assess the evidence for the benefits of drains post-operatively in spinal surgery. The identified studies have shown that drains do not reduce the incidence of complications in anterior cervical discectomy and fusion, one and two level posterior cervical fusions, lumbar laminectomies, lumbar decompressions or discectomies and posterior spinal fusion for adolescent scoliosis. Further level I and II studies are needed.
Nd:YAG laser ablation is effective in the treatment of recalcitrant verruca plantaris. However, we caution against the use of direct local anaesthesia infiltration before laser treatment.
As of 2018 cancer is responsible for almost 9.6 million deaths annually and, with an aging population, the incidence of cancer is expected to continue to rise. Surgery is an important treatment modality for patients with solid organ cancers. It has been postulated that, due to potentially overlapping processes underlying the development of malignancy and the therapeutic pathways of various anesthetic agents, the choice of anesthetic type and method of administration may affect post-operative outcomes in patients with cancer. This is a literature review of the most recent evidence extracted from various databases including PubMed, EMBASE, and the Cochrane, as well as journals and book reference lists. The review highlights the pathophysiological processes underpinning cancer development and the molecular actions of anesthetic agents, pre-clinical and retrospective studies investigating cancer and anesthetics, as well as ongoing clinical trials. Overall, there are conflicting results regarding the impact of regional vs. general anesthesia on cancer recurrence, whilst the majority of data suggest a benefit of the use of intravenous propofol over inhalational volatile anesthetics. The biological changes associated with the surgical inflammatory response offer a unique opportunity to intervene to counteract any potentially cancer-promoting effects.
The gulf between the wealthiest and poorest had been increasing even before the covid-19 destroyed the globe's health and economies. 1 Recent research indicates a growing depth of poverty, and women and children are the biggest casualties of this deepening divide. 2 The World Bank predicts the number of people in extreme poverty will increase by 70-100 million in 2021 alone. 3 Welfare programmes were often criticised as unable to deal with economic changes, such as the threat of automation and rise in flexible work. However, since March 2020, rising inequality and drastic changes to the labour market have forced governments to implement economic initiatives, such as basic income programmes, that previously would have been politically untenable. Spain, for example, has given €1015 (£900; $1200) a month to 850 000 households most in need, 4 and the US paid $1200 to all adults earning less than $99 000 annually. 5 Evidence from the many pre-existing universal basic income schemes 6 suggests they may be a valuable addition to other initiatives to alleviate poverty and improve health outcomes globally.
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