Cost and morbidity analysis of chest port insertion in adults: Outpatient clinic versus operating room placement
Conclusion Our results suggest that chest ports can be safely placed in most patients under local anesthesia in the office setting without fluoroscopy or ultrasound guidance. Future randomized controlled studies may evaluate if surgeons or interventional radiologists should routinely perform these procedures in a dedicated office setting and reserve more sophisticated facilities only for patients at high risk of technical failure. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 25, 2017 Category: General Medicine Source Type: research

WHO Safer Surgery checklist compliance amongst paediatric emergency plastic surgery patients in an UK hospital
Conclusion This audit showed a high overall level of compliance in the checklists that were scanned and available for scrutiny. We have identified the areas that most need improvement and suggest ways for doing so. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 22, 2017 Category: General Medicine Source Type: research

Tissue expansion for breast reconstruction: Methods and techniques
Conclusions TE/implant-based reconstruction has proved to be a safe, cost-effective, and reliable technique that can be performed in women with various comorbidities. Short operative time, fast recovery, and absence of donor site morbidity are other advantages over autologous breast reconstruction. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 21, 2017 Category: General Medicine Source Type: research

THD and mucopexy: Efficacy and controversy
Conclusion THD mucopexy is a safe and effective minimally invasive modality for prolapsing symptomatic haemorrhoids with acceptable complication rates and a recurrence rate of 13% majority of which could be dealt with a repeat procedure. Long terms follow up and randomised multicentre trials are warranted to compare its efficacy with that of conventional excisional surgery. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 21, 2017 Category: General Medicine Source Type: research

A prospective randomised trial of isolated pathogens of surgical site infections (SSI)
Conclusions In conclusion, surgical site infections are important complications affecting the healthcare services, the cost of hospitalization and the patient himself. Future thorough studies are expected to reveal much more data, regarding predisposing and precautionary patient and hospital characteristics. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 20, 2017 Category: General Medicine Source Type: research

Defunctioning stoma- a prognosticator for leaks in low rectal restorative cancer resection
Conclusions De-functioning ileostomy for LAR is a safe procedure with low. Morbidity Most stomas are reversible. Series highlights a late reversal contrary to the nationally recommended guidelines. Most interestingly, the study demonstrated de-functioning mitigated clinical consequences of anastomotic leak to an extent that reoperation was avoidable, in keeping with recent meta-analysis indicating a significantly low anastomotic leakage rates and reoperation. Larger study is invaluable to substantiate findings. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 20, 2017 Category: General Medicine Source Type: research

Frequency, characteristics and outcomes of Appendicular Neuroendocrine tumors: A cross-sectional study from an academic tertiary care hospital
Conclusion Carcinoid tumors of the appendix are rare and typically diagnosed incidentally. Detailed examination of routine appendectomy specimens is the key for diagnosis. Simple appendectomy suffices for tumors <2 cm for adequate clearance. Appendicular carcinoid tumors are associated with good long-term outcomes. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 20, 2017 Category: General Medicine Source Type: research

Congenital and infantile malignant melanoma of the scalp: A review
Publication date: Available online 19 July 2017 Source:Annals of Medicine and Surgery Author(s): Sohaib Tariq, Hussain Shallwani, Muhammad Waqas, Muhammad Ehsan Bari Congenital and infantile malignant melanomas are rare and typically carry poor prognosis. The purpose of this article was to review the data on congenital and infantile malignant melanomas of the scalp in order to understand its presentation, diagnosis, management, and outcomes of congenital melanoma of scalp. We searched PubMed, CINAHL and Cochrane databases. Ten cases of congenital and 3 cases of infantile malignant melanoma of scalp were identified. The di...
Source: Annals of Medicine and Surgery - July 20, 2017 Category: General Medicine Source Type: research

Solitary ulcer in cecum, mimicking a carcinoma: A case report
Conclusion The diagnosis of solitary cecal ulcer should be considered in patients presenting with RLQ abdominal pain and with history of NSAIDs consumption. Recognition of this diagnosis by surgeons, ruling out malignancies, understanding the morphologic features, and carefully taking the patient's history are essential for the diagnosis and treatment of this uncommon disease. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 20, 2017 Category: General Medicine Source Type: research

Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature
Publication date: Available online 20 July 2017 Source:Annals of Medicine and Surgery Author(s): Marco Gardani, Nicolò Bertozzi, Michele Pio Grieco, Marianna Pesce, Francesco Simonacci, PierLuigi Santi, Edoardo Raposio One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconst...
Source: Annals of Medicine and Surgery - July 20, 2017 Category: General Medicine Source Type: research

Attitudes of surgeons to the use of postoperative markers of the systemic inflammatory response following elective surgery
Conclusion Although there was a limited response the majority of surgeons surveyed measure the systemic inflammatory response following elective surgery and use CRP measurements together with clinical findings to guide postoperative care. The present results provide a baseline against which future surveys can be compared. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 20, 2017 Category: General Medicine Source Type: research

Feasibility and safety of surgical wound remote follow-up by smart phone in appendectomy: A pilot study
Conclusions The telemedicine-based follow-up, has proven to be feasible and safe for the evaluation of early postoperative complications. Patients reported high levels of satisfaction with the procedure. Telemedicine-based follow-up could become standard practice with the development of a specific mobile application. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 19, 2017 Category: General Medicine Source Type: research

Rapid onset of amiodarone induced pulmonary toxicity after lung lobe resection – A case report and review of recent literature
We present the case of a 58 year old woman who underwent thoracic surgery with lobe resection. She developed atrial fibrillation with hemodynamic-instability on the first post-operative day. We initiated amiodarone therapy and four days later she developed respiratory failure. The pulmonary function further deteriorated showing signs of an acute respiratory distress syndrome (ARDS). We therefore started mechanical ventilation, but still the gas exchange did not improve. A computer tomography-(CT)-scan presented bilateral interstitial and alveolar infiltrations. The patient also presented with leukocytosis, elevated C-react...
Source: Annals of Medicine and Surgery - July 19, 2017 Category: General Medicine Source Type: research

Rationale for a new registry on EVAR: The EXTREME study
Publication date: Available online 18 July 2017 Source:Annals of Medicine and Surgery Author(s): Pasqualino Sirignano, Wassim Mansour, Laura Capoccia, Francesco Speziale To report rationale a physician-initiated study: Expanding Indications for Treatment with Standard EVAR in Patients with Challenging Anatomies, a Multi-Centric Prospective Evaluation - EXTREME. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 18, 2017 Category: General Medicine Source Type: research

Comparison between CT Net enhancement and PET/CT SUV for N staging of gastric cancer: A case series
Conclusion CT Net enhancement represents an accurate tool for N staging of gastric cancer and could be considered as the CT corresponding quantitative parameter of F-FDG PET/CT SUV. It could be applied in the clinical practice for differentiating reactive lymph nodes from metastatic ones improving accuracy and specificity of CT. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 15, 2017 Category: General Medicine Source Type: research

Adipose-derived stem cells: Comparison between two methods of isolation for clinical applications
Conclusion Based on data collected, from the same amount of lipoaspirate the ME procedure allowed to isolate a greater number of ASCs (25,9%) compared to the MC one (5%). (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 9, 2017 Category: General Medicine Source Type: research

An extensive swelling in the anterior mandible – A case report
Conclusion We often neglect to include uncommon lesions in the differential diagnosis, which may lead to inadequacy in the management protocol. Whenever possible, incisional biopsy should be performed to confirm the lesion before surgical enucleation. Here we present a case in which we were fortunate enough to diagnose the lesion by an incisional biopsy and managed according to the standard protocol. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 7, 2017 Category: General Medicine Source Type: research

Lesson learnt from a migrated drain: A case report
Conclusion Every use of drain should be weighed for its needs and risks. Proper precautions during drain placement avoid unnecessary complications, morbidity and prolonged hospital stay. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 6, 2017 Category: General Medicine Source Type: research

Acute pancreatitis: A 7 year review of the epidemiology, aetiology and outcome from a tertiary hospital in Jamaica
Conclusion The incidence of AP was 74/100,000 hospital admissions annually. There was an unusual female preponderance, with biliary pancreatitis being the most common type occurring at an equal frequency among males and females. Only 12.2% of the total cases seen were severe. The case fatality rate was 2%. Local health policy should target timely interventions for biliary pancreatitis and should also address the local factors affecting disease severity. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 5, 2017 Category: General Medicine Source Type: research

Dysphagia caused by giant schwannoma of the supraglottic oropharynx: A case report and review of the literature
Conclusion Although rare, schwannomas do occasionally occur in the supraglottic oropharynx. When dysphagia is present, a thorough diagnostic procedure should be performed to evaluate the morphology and function of the upper aerodigestive tract. MRI is sensitive and specific in the diagnosis of schwannoma. And the best treatment of choice is complete excision with preservation of functions. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 5, 2017 Category: General Medicine Source Type: research

Bleeding complications post ultrasound guided renal biopsy – A single centre experience from Pakistan
Conclusions Percutaneous kidney biopsy is a relatively safe procedure. Complication rates following the procedure are minimal. It is important that all nephrology programs train the trainees in performing biopsies, so that there is a wider clinical use of this important investigation even in underprivileged & developing countries. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - July 5, 2017 Category: General Medicine Source Type: research

A case report of pneumo-retro-peritoneum: An unusual presentation of ischio-rectal abscess
Conclusion Abdominal symptoms are rare in ischio-rectal abscess, but they must be kept in mind. Proper diagnosis may avoid a negative laparotomy. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 27, 2017 Category: General Medicine Source Type: research

Procedure, applications, and outcomes of autologous fat grafting
Conclusions Lipofilling is a low-risk procedure that can be used to correct soft-tissue defects in the face, trunk, and extremities, with minimal discomfort for patients. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 27, 2017 Category: General Medicine Source Type: research

New method of indocyanine green fluorescence sentinel node mapping for early gastric cancer
Conclusion Our method made identification of ICG positive lymph nodes easy in SN mapping in back-table under room light. Although further accumulation and analysis are necessary, we may be able to apply this method for intraoperative SN mapping of laparoscopic gastric cancer surgey. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 27, 2017 Category: General Medicine Source Type: research

Potential cost savings by minimisation of blood sample delays on care decision making in urgent care services
Conclusion Sample rejection rate is high and is associated with increased in-hospital stay and cost. Blood sampling technique impacts on rejection rates. Reduction in sample rejection rates in emergency care areas in acute hospitals has the potential to impact on patient flow and reduce cost. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 27, 2017 Category: General Medicine Source Type: research

The biological and clinical basis for the use of adipose-derived stem cells in the field of wound healing
Publication date: Available online 23 June 2017 Source:Annals of Medicine and Surgery Author(s): Nicolò Bertozzi, Francesco Simonacci, Michele Pio Grieco, Eugenio Grignaffini, Edoardo Raposio Worldwide, hard-to-heal lower limb wounds are estimated to affect 1.5–3% of the adult population with a treatment-related annual cost of $10 billion. Thus, chronic skin ulcers of the lower limb are a matter of economic and public concern. Over the years, multiple medical and surgical approaches have been proposed but they are still inadequate, and no effective therapy yet exists. Regenerative medicine and stem cell-based...
Source: Annals of Medicine and Surgery - June 24, 2017 Category: General Medicine Source Type: research

Porocarcinoma; presentation and management, a meta-analysis of 453 cases
Conclusions Porocarcinoma is an aggressive skin cancer. Surgery is the main modality of treatment. Systematic review registration number reviewregistry233. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 21, 2017 Category: General Medicine Source Type: research

Maxillary artery based flaps for oral cavity reconstruction, a review
Conclusion Maxillary artery based flaps should be considered as an option especially in previously radiotherapy/surgically operated patients with facial vessels sacrifice. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 21, 2017 Category: General Medicine Source Type: research

The major thoracic vascular invasion of lung cancer
Conclusion The positive predictive value of the preoperative CT findings for tumor invasion of the thoracic vessels was low. Therefore, surgical opportunities that offer the chance of a cure shouldn't be missed in advanced lung cancer patients because the tumor is located near the major thoracic vessels on preoperative CT. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 21, 2017 Category: General Medicine Source Type: research

Effect of adjuvant chemotherapy after pulmonary metastasectomy on the prognosis of colorectal cancer
Conclusions Adjuvant chemotherapy after curative resection of lung metastases might strongly affect the prognosis of metastatic CRC patients. Even patients with single metastatic lesions and normal preoperative CEA level appeared to receive benefits from such chemotherapy. Narrowing of suitable candidates by predicting the effects of systemic chemotherapy and prospective randomized studies are needed. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 21, 2017 Category: General Medicine Source Type: research

Potential cost savings by minimisation of delays on care decision making in urgent care services
Conclusion Sample rejection rate is high and is associated with increased in-hospital stay and cost. Blood sampling technique impacts on rejection rates. Reduction in sample rejection rates in emergency care areas in acute hospitals has the potential to impact on patient flow and reduce cost. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 17, 2017 Category: General Medicine Source Type: research

Induction of autoimmune abdominal aortic aneurysm in pigs - A novel large animal model
Conclusion We developed a novel large animal AAA model by infrarenal aortic sheep-to-pig xenograph transplantation resulting in autoimmune AAA induction with continuously progressive aneurysmal growth. This model can be used to provide a better understand the autoimmune aspect of AAA formation in large animals. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 16, 2017 Category: General Medicine Source Type: research

Improving antibiotic prophylaxis in gastrointestinal surgery patients: A quality improvement project
Conclusions Our quality improvement intervention was successful in improving SAP for patients undergoing gastrointestinal surgery at our institution. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 16, 2017 Category: General Medicine Source Type: research

Temporal artery biopsy in the diagnosis of giant cell arteritis: does the end justify the means?
Conclusion Overall 13.2% of our biopsies were positive for GCA and 87.3% of biopsy negative patients continued prednisolone therapy on clinical grounds. In the face of new diagnostic tests (high resolution MRI (Magnetic Resonance Imaging), colour duplex USS (Ultra Sound Scan) and PET (Positive Emission Topography) can we justify invasive surgery to all patients on histological grounds when the results may not alter management? Further investigation is needed directly comparing newer imaging modalities to histology. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 16, 2017 Category: General Medicine Source Type: research

Evaluating validity of current criteria for judgment passing ER rotation among internee medical students
Conclusions According to association between successfully completions of training in emergency medicine and self-assessment questionnaire, it seems current criteria for judgment passing emergency medicine rotation is valid as well as we recommended using self-assessment for evaluating validity of such testes. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 16, 2017 Category: General Medicine Source Type: research

Diagnostic approaches and treatment of eosinophilic esophagitis. A review article
Publication date: Available online 16 June 2017 Source:Annals of Medicine and Surgery Author(s): Hossein Akhondi Eosinophilic Esophagitis (EoE) is a condition that involves eosinophilic influx into the esophageal epithelium. It affects both children and adults; Adults present with dysphagia whereas children with vague abdominal complaints. The clinical symptoms as well as pathologic features of EoE and gastro esophageal reflux disease (GERD) are similar. Since eosinophilia in the esophagus is a non-specific finding, the clinical presentation in conjunction with endoscopic findings and pathology, is crucial in determining ...
Source: Annals of Medicine and Surgery - June 16, 2017 Category: General Medicine Source Type: research

Is transoral robotic surgery a safe and effective multilevel treatment for obstructive sleep apnoea in obese patients following failure of conventional treatment(s)?
Publication date: July 2017 Source:Annals of Medicine and Surgery, Volume 19 Author(s): George Garas, Anthousa Kythreotou, Christos Georgalas, Asit Arora, Bhik Kotecha, Floyd C. Holsinger, David G. Grant, Neil Tolley A best evidence topic was written according to a structured protocol. The question addressed was whether TransOral Robotic Surgery (TORS) is a safe and effective multilevel treatment for Obstructive Sleep Apnoea (OSA) in obese patients following failure of conventional treatment(s). A total of 39 papers were identified using the reported searches of which 5 represented the best evidence to answer the clinical...
Source: Annals of Medicine and Surgery - June 10, 2017 Category: General Medicine Source Type: research

Rare mycotic aneurysms of internal jugular vein and innominate vein secondary to untreated parapharyngeal abscess: A case report
We report a 31 year old woman presented with three months history of large untreated parapharyngeal abscess and bleeding from the mouth. On evaluation chest CT scan identified the abscess extending down to the superior mediastinum and multiple small lung abscesses. Echocardiography showed tricuspid valve insufficiency. Patient was brought to the operating room (OR) and intra-operatively it was found that she had multiple large mycotic pseudoaneurysms of the internal jugular vein and right brachiocephalic veins. All these pseudoaneurysms were repaired with pericardial patches under cardiopulmonary bypass. Patient did well i...
Source: Annals of Medicine and Surgery - June 9, 2017 Category: General Medicine Source Type: research

Mean platelet volume and serum uric acid in neonatal sepsis: A case-control study
Conclusions MPV could be assessed in the early diagnosis of neonatal sepsis while SUA level has lower sensitivity in neonatal sepsis. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 8, 2017 Category: General Medicine Source Type: research

A bibliometric analysis of the citation classics of acute appendicitis
Conclusions Bibliometric analysis of the citation classics in a given field can provide interesting insights into the relationship between the quality of research outputs and clinical practice. The study of acute appendicitis remains an active field of research with a growing body of higher quality evidence underpinning our clinical practice. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 7, 2017 Category: General Medicine Source Type: research

Efficacy of submucosal epinephrine injection for the prevention of postpolypectomy bleeding: A meta-analysis of randomized controlled studies
Conclusion The routine use of prophylaxis submucosal epinephrine injection is safe and beneficial preventing postpolypectomy bleeding. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 7, 2017 Category: General Medicine Source Type: research

Hernias- Is it a primary defect or a systemic disorder? Role of collagen III in all hernias- A case control study
Conclusion This study signifies that ventral, recurrent and primary inguinal hernias are not just caused because of a primary defect but an acquired disorder with respect to collagen distribution. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 7, 2017 Category: General Medicine Source Type: research

Clinical outcomes of self-expandable metal stent (SEMS) placement as palliative treatment for malignant colorectal obstruction: A single-center study from Japan
Conclusion SEMS placement as a palliative treatment is likely to fail within a year, leading to re-occlusion. It is very important to maintain vigilant monitoring using X-ray, CT, and colonoscopy after SEMS placement, with close cooperation between the endoscopist and surgeon. A logistic framework involving careful follow-up, even in the absence of symptoms, and a combined team involving endoscopists and surgeons should be established to support re-intervention and surgery. We recommend vigilant monitoring of patients who received SEMS placement for palliation of malignant colorectal obstruction. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 4, 2017 Category: General Medicine Source Type: research

Carcinosarcoma of the maxillary sinus: A rare case report
Conclusion This is an aggressive tumor, rapidly progressive with a poor prognosis. The management of this rare condition remains undetermined. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 3, 2017 Category: General Medicine Source Type: research

Knot free technique for Laparoscopic Ventral Mesh Rectopexy
Conclusion Our study with limitations of small group and relatively shorter follow up has proven to be a safe technique. This technique has a potential of replacing intra or extracorporeal knot with endo clips and requires less time compared to conventional suturing. It also advantage of having a minimal learning curve. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 2, 2017 Category: General Medicine Source Type: research

Role of collagen 3 in ventral recurrent and primary inguinal hernias - A case control study
Conclusion This study signifies that ventral, recurrent and primary inguinal hernias are not just caused because of a primary defect but an acquired disorder with respect to collagen distribution. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - June 1, 2017 Category: General Medicine Source Type: research

Exposure to the drug company marketing in Greece: Interactions and attitudes in a non-regulated environment for medical students
Conclusion Our results suggest that medical students in Greece are notably exposed to pharmaceutical industry marketing and their conflicting answers demonstrate that they are inadequately prepared for this interaction. Interventions are needed so that students are prepared and able to manage these interactions critically. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - May 30, 2017 Category: General Medicine Source Type: research

Serum intestinal fatty acid binding protein level for early diagnosis and prediction of severity of necrotizing enterocolitis in the preterm infant (case series)
Conclusions Serial measurements of serum I-FABP levels may be a useful marker for early diagnosis and prediction of disease severity in NEC. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - May 27, 2017 Category: General Medicine Source Type: research

Does additional reconstruction of the anterolateral ligament during a primary anterior cruciate ligament reconstruction affect tibial rotational laxity – A case series
Conclusion Our findings are based primarily in anaesthetized patients, with kinematic values at time-zero postoperatively. Patients presenting with significant rotational instability following a primary ACL injury and assessed to have a grade-3 pivot-shift may benefit from dual-ligament reconstruction. Further research is required to assess long-term patient-centered clinical outcomes. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - May 25, 2017 Category: General Medicine Source Type: research

Subtotal laparoscopic cholecystectomy influences the rate of conversion in patients with difficult laparoscopic cholecystectomy: Case series
Conclusion SLC is feasible, safe and can reduce the rate of conversion for patients with difficult laporoscopic cholecystectomy. Sub-total laparoscopic cholecystectomy is not a substitute to conversion and in difficult conditions it is not a failure for the surgeon but a wisdom. (Source: Annals of Medicine and Surgery)
Source: Annals of Medicine and Surgery - May 25, 2017 Category: General Medicine Source Type: research