http://hdl.handle.net/2440/10017 Search the Channel search http://digital.library.adelaide.edu.au/dspace/simple-search http://hdl.handle.net/2440/56087 Title: Evaluation and stages of surgical innovations<br/><br/>Author: Barkun, Jeffrey; Feldman, Liane S.; Aronson, Jeffrey K.; Maddern, Guy John; Strasberg, Steven M.<br/><br/>Abstract: Surgical innovation is an important part of surgical practice. Its assessment is complex because of idiosyncrasies related to surgical practice, but necessary so that introduction and adoption of surgical innovations can derive from evidence-based principles rather than trial and error. A regulatory framework is also desirable to protect patients against the potential harms of any novel procedure. In this first of three Series papers on surgical innovation and evaluation, we propose a five-stage paradigm to describe the development of innovative surgical procedures. http://hdl.handle.net/2440/53879 Title: Influence of bioengineered skin substitutes on diabetic foot ulcer and venous leg ulcer outcomes<br/><br/>Author: Barber, Christine; Watt, A. D.; Pham, C.; Humphreys, K.; Penington, A.; Mutimer, Keith; Edwards, M.; Maddern, Guy John<br/><br/>Abstract: This systematic review indicates that bioengineered skin substitutes with a dermal component may improve healing outcomes in diabetic foot ulcers and venous leg ulcers. However, better designed trials with longer follow-up periods are needed. http://hdl.handle.net/2440/52578 Title: Systematic review of endovenous laser therapy versus surgery for the treatment of saphenous varicose veins<br/><br/>Author: Hoggan, Benjamin Lee; Cameron, Alun; Maddern, Guy John<br/><br/>Abstract: This systematic review compares the safety and efficacy of endovenous laser therapy (ELT) and surgery involving saphenous ligation and stripping as treatments for varicose veins. Systematic searches of medical bibliographic databases, the Internet and lists of references were conducted in August 2007 and April 2008 to identify relevant primary studies. Inclusion of papers was resolved through application of a predetermined protocol. Information on the safety and effectiveness of ELT and surgery was analyzed. Fifty-nine studies were included, with seven studies directly comparing ELT with surgery. Serious adverse events after ELT or surgery were rare. While occurrence rates of some minor adverse events appeared higher after ELT in collated data, comparative studies commonly favored ELT over surgery. Few differences were apparent between treatments with respect to clinical effectiveness outcomes, although long-term follow-up was lacking. Nonclinical effectiveness outcomes generally favored ELT over surgery in the first 2 months after treatment. ELT appears to be at least as safe as surgery. While ELT offers short-term benefits and appears to be as clinically effective as surgery up to 12 months after treatment, clinical trials with a minimum of 3 years of follow-up are required to establish the enduring effectiveness of ELT. http://hdl.handle.net/2440/49017 Title: Tissue nitrosothiol levels in acute ulcerative colitis A step in disease induction?<br/><br/>Author: Roediger, W. E. W.; Cummins, Adrian Gerard; Cowled, Prudence Anne<br/><br/>Abstract: Background and aims: Production of luminal nitric oxide (NO) in the colon is significantly increased in ulcerative colitis (UC) due to bacterial metabolism or activated immune cells. The effect on tissues of prolonged elevation of nitric oxide is unknown. Formation of nitrosothiols has been discounted as these occur under acidic conditions which nevertheless may prevail in acute colitis. The aim was to measure nitrosothiol formation in colonocytes in acute colitis as well as to assess nitrosation of CoA in vitro.Materials and methods: Fresh rectal biopsies obtained at colonoscopies of cases with acute colitis, newly diagnosed or after recurrent attacks, were analysed. Exposure to glutaraldehyde/formaldehyde was avoided and samples stored in the dark at −80 °C. After mechanical homogenization nitrosothiols were measured with the Saville-Griess reaction with and without exposure to mercuric chloride. The reaction with sulphanilamide was measured at 540 nm after azo dye coupling. By calibration curves with GSNO and tissue protein measurement (Bradford reaction) results were expressed as nmoles/mg protein. Purified samples of CoA were obtained for UV spectroscopic analysis after exposure to nitrite or sodium sulphide.Results: Nitrosothiols were not measureable in tissues exposed to formaldehyde. Nitrosothiol levels were 129.3 ± 25.6 (n = 6) in acute UC compared with healthy controls of 53.2 ± 13.8 (n = 6) (p &lt; 0.02). Nitrosothiols of CoA were measureable at acidic pH (2.0) and increased by the presence of sodium sulphide (0.5 mM). Nitroso-CoA formation to a lesser degree occurred at higher pH (6.9) but amplification with sulphide was not clearly identified.Conclusions: Elevated tissue nitrosothiols are found in association with acute colitis. As both CoA and glutathione are known to be depleted in UC, results suggest that these agents could be diminished by nitrosothiol formation.<br/><br/>Description: Copyright © 2008 Published by Elsevier Inc.