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Biomedical subjects

L Schlossberg

Publications and source records attributed to L Schlossberg.

5 recordsLinked to original sources
PubMed1999

Extended subcostal hinge incision for right hepatic lobectomy.

The safe performance of a right hepatic lobectomy requires adequate exposure of the hepatic veins and of the suprahepatic vena cava. An extended subcostal or midline incision is commonly used to provide exposure for this operation. The technique for an extended subcostal incision that uses the natural hinge mechanism of the rib cage to provide exposure to the right upper quadrant is described. This approach provides adequate exposure during a difficult hepatectomy, avoiding the need for a thoracotomy or sternotomy.

Hepatectomy↗
PubMed1999

Anatomical anterior exenteration with urethral and vaginal preservation: illustrated surgical method.

PURPOSE: We describe in detail a method for urethral and vaginal preservation in women considering orthotopic urinary tract reconstruction after bladder removal. MATERIALS AND METHODS: We retrospectively reviewed the pathological reports of patients treated with anterior exenteration at our hospital between 1984 and 1997 for specific evidence of urethral, vaginal, cervical or uterine involvement by the primary bladder tumor. Based on our findings we describe our approach to anterior exenteration in 6 patients. RESULTS: A total of 46 patients were treated at our center with en bloc anterior exenteration and pelvic lymphadenectomy for primary bladder cancer between 1984 and 1997. In 7 patients (15%) pathological review of the surgical specimen documented urethral involvement by the primary tumor. In 1 patient (2%) microscopic evidence of tumor was identified in the cervix and 1 (2%) had tumor extension to the vagina documented in the final pathology report. CONCLUSIONS: The observed rates of vaginal and urethral involvement agree with those reported by others, and suggest that in the majority of women treated with anterior exenteration sacrifice of the urethra and vagina is usually not necessary from an oncological perspective. This procedure is particularly appropriate in women concerned with postoperative sexual function and those considering orthotopic reconstruction of the lower urinary tract after exenterative bladder cancer surgery.

Female↗
PubMed1989

Influence of a preventive care educational intervention on physician knowledge, attitudes, beliefs, and practice.

We evaluated the effect of a three-part intervention on knowledge, attitudes, beliefs, and practices relevant to preventive care. A group of 13 second-year internal medicine residents (Group I) were exposed to a lecture, chart-based reminder, and biweekly feedback during a 3-month ambulatory care rotation. The remaining two groups of residents (Group II, n = 12; Group III, n = 11) were not exposed to the intervention. We performed a chart review to assess preventive care practice at a clinical site separate from the intervention and surveyed residents to assess preventive care knowledge, self-reported practice, professional attitudes, and health beliefs. Chart reviews revealed the intervention to be associated with improved performance of preventive care (0.52 vs 0.35 and 0.42, P = 0.01). In addition, the intervention was associated with improved scores for preventive care knowledge (90 vs 74 and 77, P = 0.001) and self-reported practice (85 vs 65 and 72, P = 0.007). Although attitudes toward prevention and health locus of control were not measurably influenced by the intervention, stepwise multiple linear regression analysis demonstrated these factors to be independently related to preventive practice. Our data support the notion that physician preventive practice is subject to a variety of influences involving not only knowledge, and practice environment, but also training, professional attitudes, and health beliefs.

Ambulatory Care↗