The Gender Disparity in Operative Opportunities for Trainee Surgeons: A Review.

Introduction: Assessing gender disparity in surgical trainees' operative opportunities and experience quantifies implicit gender bias and reflects a summation of many smaller biased interactions within the operating room environment. Highlighting gender disparity in surgery informs a platform for advocacy.

Methods: A systematic literature search was performed using Medline, Web of Science, OpenMD and Science Direct consistent with the Preferred Reporting Items for Systematic Reviews and Metanalysis guidelines.

Brain tumour patients' use of social media for disease management: Current practices and implications for the future.

Objective: The role of social media in disease management is evolving. We aimed to define current use of social media for patients with primary brain tumours.

Methods: This was a single-centre cross-sectional prospective study; a questionnaire was administered on electronic tablets to patients in the Outpatient Department of Royal Melbourne Hospital.

Challenges in the Australasian neurosurgery training program: who should be trained and where should they train?

Objective: Neurosurgical training poses particular challenges in Australia and New Zealand, given the large landmass, small population, and widely separated, often small, neurosurgical units. Such factors have necessitated a move away from autonomous, single-institution-based training to the selection of trainees by a centralized binational process. The success of this system is based on rigorous standardized evaluation of candidates' academic achievements, anatomical knowledge, references, and interview performance.

Successful resolution of the ophthalmic manifestations of a falcotentorial meningioma through Cerebrospinal fluid diversion.

We report the case of a falcotentorial meningioma presenting only with binocular, horizontal diplopia in an otherwise healthy sixty-two-year old male. Review of the established literature highlights a lack of consensus regarding management of this extremely rare pineal region tumor. Complete surgical resection ultimately remains the ideal therapeutic option but surgical excision continues to bear serious risk of neurologic and ophthalmic morbidity, including hemianopia and cortical visual impairment.

Acute cervical cord syrinx after aneurysmal subarachnoid haemorrhage.

We report the acute formation of a cervical cord syrinx after aneurysmal subarachnoid haemorrhage, followed by spontaneous resolution. To our knowledge, not previously described in the literature, this case provides further insights into the pathophysiology of syrinx formation, and is discussed with reference to prevailing theories.

A systematic review of types and efficacy of online interventions for cancer patients.

Objective: This review examines the evidence-based literature surrounding the use of online resources for adult cancer patients. The focus is online resources that connect patients with their healthcare clinician and with supportive and educational resources, their efficacy and the outcome measures used to assess them.

Methods: The following databases were systematically searched for relevant literature: MEDLINE, PsychINFO, Cochrane Central Register of Controlled Trials, CINAHL, Inspec and Computers and Applied Science.

Leukoaraiosis and early neurological recovery after intravenous thrombolysis.

Background: Early neurological recovery after intravenous thrombolysis (IVT) is associated with favorable outcome after acute ischemic stroke. Leukoaraiosis, a marker of chronic ischemia, is a possible negative predictive factor of early recovery. However, its negative attenuating effects remain inadequately studied, leading to uncertainty in the prediction of outcomes after IVT.

Spontaneous Thrombosis of a Bicuspid Aortic valve due to Primary Antiphospholipid Syndrome.

We present the case of a 51-year-old man who was admitted as an emergency with spontaneous thrombosis of the aortic valve and ascending aorta. At operation he was found to have a congenitally bicuspid aortic valve and subsequent investigation revealed primary antiphospholipid syndrome. He underwent successful removal of the thrombus combined with mechanical replacement of the aortic valve.

Evaluating a Web-based graduate level nursing ethics course: thumbs up or thumbs down?

Background: This article discusses the course design, experiential findings, and evaluation of a Web-based course for graduate nurses examining professional health care practice and ethical issues.

Method: Using course input and evaluative data, the article addresses student and teacher perceptions of use of a Web-based delivery mode for graduate level courses and the appropriateness of this ethics course for graduate level students.

Results: Evaluative data supported existing knowledge concerning pros and cons of Web-based education.

Successful retrieval of a knotted pulmonary artery catheter trapped in the right ventricle using a dormier basket.

We report the case of a 71 year old patient in whom a pulmonary artery catheter (Swan Ganz) formed a knot which was fixed within the right ventricle in the region of the tricuspid valve annulus. The catheter was successfully dislodged to the right atrium, subsequently snared by a dormier basket advanced from the right femoral vein and retrieved by localised cut down of the femoral vein.

Development and testing of the ethical reasoning tool (ERT): an instrument to measure the ethical reasoning of nurses.

Ascertaining the thinking of professionals as they are confronted with ethical practice issues is a prerequisite to understanding ethical decision making. Before researchers or educators can examine the effectiveness of various approaches to ethics teaching and learning, there is a need for reliable and valid tools to assess practitioners' cognition. A potential problem with the few measuring instruments currently available is the fact that they ask subjects to rank order existing lists of issues.

Critical reflections about professional ethical stances: have we lost sight of the major objectives?

Increasingly, the professional literature reflects a call for the adoption of a (feminist) "ethic of caring" as a model for moral education is nursing. But what is not clear is the relationship between "care" and "ethics, " or between an "ethic of caring" and "moral education." Has ethics, and the issue of ethics education for nurses, become entangled with what may be a separate issue of an "ethic of caring" for the nursing profession? This article presents an overview of evolving ethical stances of three professions, and shows how the dichotomous views within philosophy and psychology have strongly influenced ethical thought in nursing.

Effects of lisinopril on congestive heart failure in normotensive patients with diastolic dysfunction but intact systolic function.

This study examined the effects of lisinopril on diastolic function in 12 normotensive patients (mean age 72 years) with symptomatic congestive heart failure, intact left ventricular systolic function and abnormal diastolic function secondary to ischaemic heart disease in a placebo-controlled double blind crossover study, with each treatment dosed orally for 5 continuous weeks. Compared to placebo, lisinopril significantly decreased blood pressure, increased plasma renin activity without altering heart rate or plasma norepinephrine. There was no statistically significant improvement with lisinopril in radionuclide derived peak filling rate and time to peak filling rate, in Doppler echocardiographic measurements of the ratio of peak flow velocity in early diastole to the peak flow velocity of atrial contraction (E:A ratio) and in visual analogue scales of symptoms.

Taurolin for the prevention of parenteral nutrition related infection: antimicrobial activity and long-term use.

A case is described in which bis (1, 1 dioxoperhydro-1, 2, 4-thiadiazinyl-4-) methane (Taurolin) has saferly been administered on a long term basis to prevent recurrent sepsis in a patient receiving parenteral nutrition. A 26-year-old male with Crohn's disease receiving parenteral nutrition suffered repeated episodes of sepsis and developed an infected intra-atrial thrombus despite repeated courses of antimicrobial chemotherapy and surgical intervention. Continued parenteral nutrition was essential du5e to intestinal failure.

Plasma brain natriuretic peptide as an indicator for angiotensin-converting-enzyme inhibition after myocardial infarction.

Brain natriuretic peptide (BNP) is a cardiac ventricular hormone that may be a sensitive and specific marker of changes in ventricular function. In a prospective, randomised open trial with 16 patients followed for 6 months after first Q wave anterior myocardial infarction we set out to determine: whether BNP concentrations are raised acutely, the effect on circulating BNP of angiotensin-converting enzyme (ACE) inhibition, how BNP and atrial natriuretic peptide (ANP) concentrations compared as correlates of left-ventricular ejection fraction, and whether plasma BNP concentrations could distinguish patients with low (< 40%) and relatively preserved (> 40%) ejection fractions. Plasma concentrations of BNP measured on days 2, 7, 8, 42, and 180 postinfarction were significantly raised in patients compared with normal controls and to a proportionately greater degree than ANP concentrations.

Effectiveness of captopril in reversing renal vasoconstriction after Q-wave acute myocardial infarction.

The purpose of this investigation was to study whether favorable renal effects might contribute to the influence of captopril in offsetting ventricular dilatation after infarction. Effective renal plasma flow and glomerular filtration rate were estimated by isotope injection methods in 20 patients on days 2, 7, 8, 42 and 180 after a first transmural anterior myocardial infarction. After measurements on day 7, patients were randomized to receive either captopril 25 mg 3 times daily (n = 10) or placebo (n = 10) for the remainder of the study.