Recruiting physicians to core medical training: how should it be done?

Parathyroid imaging: how good is it and how should it be done?

Hypersecretion of parathormone in primary hyperparathyroidism is common, occurring in approximately 1 in 500 women and 1 in 2,000 men per year in their fifth to seventh decades of life. This has been suggested from the literature to be primarily the result of a parathyroid adenoma (80-85% of cases), hyperplasia involving more than 1 gland, usually with all 4 glands being involved (10-15% of cas...

Laparoscopic Appendectomy: Why It Should Be Done

OBJECTIVE Notwithstanding its widely perceived advantages, laparoscopic appendectomy has not yet met with universal acceptance. The aim of the present work is to illustrate retrospectively the results of a case-control experience with laparoscopic versus open appendectomy carried out at our institution. METHODS Between January 1993 and November 2000, 555 patients (M:F = 210:345; mean age 25.2...

How high should it be?

Should physicians be gatekeepers of medical resources?

Physicians have an ethical responsibility to their patients to offer the best available medical care. This responsibility conflicts with their role as gatekeepers of the limited health care resources available for all patients collectively. It is ethically untenable to expect doctors to face this trade-off during each patient encounter; the physician cannot be expected to compromise the wellbei...

Tubeless Percutaneous Nephrolithotripsy: When it should be done?

Percutaneous Nephrolithotripsy (PCNL) has become a standard method to approach large urinary stones (over 2cm) located in the kidney or proximal ureter. Among the minimal invasive urological procedures, PCNL still remains as the most morbid treatment. The routine of using post-operative nephrostomy is still controversial, and some authors supports that tubeless PCNL could be as safe as standard...