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Biomedical subjects

Chris D Tzarnas

Publications and source records attributed to Chris D Tzarnas.

7 recordsLinked to original sources
PubMed2006

Appendiceal diverticulitis.

The incidence of appendiceal diverticulitis in pathologic specimens is 0.004 to 2.1 per cent and is unusual in younger patients. Despite being first described in 1893, this condition is commonly dismissed by surgeons and pathologists as a variant of true appendicitis. However, appendiceal diverticulitis is a discrete clinical process that must be considered in the appropriate setting because of the much higher risk of perforation. The average age is older, the pain is often intermittent, and although it can be localized in the right lower abdominal quadrant, it is of longer duration. Although no further treatment in addition to appendectomy is needed, it is important that surgeons be aware of this condition, as the clinical presentation can be different from the classical acute appendicitis picture. Patients often seek medical treatment much later than those with classic appendicitis, and if there is a delay in establishing the correct diagnosis, perforation within the mesentery is found at the time of operation. Also, it is often mistakenly identified as carcinoma and it has higher rate of perforation and a longer convaslescence. We describe a case of a 42-year-old man and review the literature.

Adult↗
PubMed2003

Transfusion requirements for TRAM flap postmastectomy breast reconstruction.

The transverse rectus abdominis musculocutaneous (TRAM) flap is a commonly used method for autologous tissue postmastectomy breast reconstruction. It is a major operative procedure, and some have argued that it needlessly exposes patients to increased risk of complications and blood transfusions. In this series the authors review their experience with 105 consecutive complex postmastectomy breast reconstructions, limited to double-pedicle flaps, identifying complications rates and blood transfusion requirements. Blood transfusions were required in 2.8% of patients undergoing bipedicle or bilateral TRAM flap breast reconstruction. Blood transfusions were only required in patients who experienced a complication. Obesity was associated with an increased rate of complications and blood transfusion. Routine typing and cross-matching of blood and self-donation of blood may not be required for TRAM flap breast reconstruction in low-risk patients.

Adult↗
PubMed2002

Salvage of total esophageal reconstruction with microvascular free left colon flap.

Esophageal reconstruction has been achieved with a variety of innovative surgical techniques, including colonic interposition, gastric pull-up, pedicled, and free jejunal grafts. The authors describe an unusual case of complete thoracic esophageal reconstruction, necessitating an entirely free microvascular colon interposition as a salvage procedure to reconstitute the alimentary tract from the neck to the abdomen. To their knowledge, this specific method of reconstruction of the esophagus has not been previously reported.

Colon↗
PubMedDate not supplied

Agenesis of the gallbladder.

Agenesis of the gallbladder, with normal bile ducts, is a rare congenital condition occurring in 13 to 65 people out of a population of 100,000 and probably results from a failure of the gallbladder bud to develop or vacuolize in utero. Reports of a familial tendency toward this condition may suggest screening of asymptomatic family members and speed treatment when symptoms manifest, thus avoiding surgery. Choledocholithiasis in patients with gallbladder agenesis is rare, the stones found are usually small, and patients had invariably first presented with jaundice. The authors describe a case of a 23-year-old patient with gallbladder agenesis and a large choledochal calculus and without jaundice at presentation. A review of the literature is presented.

Abdominal Pain↗
PubMedDate not supplied

Audition electives during surgical residency and selection for post-residency fellowship positions.

PURPOSE: This study sought to determine the impact of surgical resident elective rotations, termed "audition" electives, upon the selection processes of surgical subspecialty residency positions, and to establish the incidence and character of resident personal contact before selection with the program where they ultimately located in order to appropriately council residents in achieving their educational and professional goals. METHODS: A national survey of all surgical subspecialty programs for academic year 1999/2000 was conducted to determine whether the current first-year subspecialty residents had been on a clinical rotation of the subspecialty at their institution during their general surgery residency, had participated in research efforts of the specific subspecialty at their institution, and whether the resident's prerequisite general surgery training was obtained at their parent sponsoring institution. RESULTS: Seventy-two percent of 348 programs responded, representing 396 beginning surgical subspecialty residents for the surveyed academic year. Overall, 73% of first-year surgical subspecialty residents did not have direct prior personal contact with their subspecialty program either through a clinical rotation at the institution or through research as a general surgery resident. Eighty-four percent of first-year surgical subspecialty residents did not complete their general surgery residency at the parent sponsoring institution of the subspecialty program. CONCLUSIONS: An audition elective does not appear to significantly influence the process of surgical subspecialty resident selection. The findings further validate the fairness of the selection processes.

Journal Article↗