Andrology. Origin and development of a special discipline in medicine. Reflection and view in the future

A general survey comments on the problems of andrology as a special medica discipline. A retrospective and an outlook concerning the different future possibilities of andrology is given. Special emphasis is placed on: examination of the ejaculate, morphology of the testicles, andrological training and further education; in the discussion of the future prospects special consideration is given to the responsibility of andrologists--also with respect to in-vitro-fertilization--and the significance of andrology for the inhabitants of the Third World.     

Vulnerology: a new term to describe the discipline of wound care

Although wound healing is probably the most critical aspect of essential medical and surgical care, it has been neglected for a long time. With the tremendous surge over the last two decades in basic research, wound healing is emerging as a well‐defined medical entity transcending existing specialties and subdivisions. In view of the multitude of health professionals interested in the field of wounds and wound healing, it seems reasonably warranted to group them under one and single appellation. We suggest ‘vulnerology’ as a new term to describe the discipline of wound care.     

A transition to discipline curriculum for pediatric surgery trainees: Evaluation of a pediatric surgery boot camp from 2017 to 2018

IntroductionBoot camps seek to impart knowledge and skills for individuals entering new roles. We sought to evaluate knowledge, skills, and confidence of in-coming pediatric surgery trainees with a 2.5-day pediatric surgery boot camp.MethodsA curriculum included key aspects of pediatric surgery delivered during interactive lectures, small group discussions, and simulation. With REB approval, participant demographics were collected. Pre- and posttests assessed knowledge and trainee confidence. Comparative statistics and multivariate analysis of variance (MANOVA) were performed.ResultsBetween 2017 and 2018, 16 individuals from North American pediatric surgery training programs participated in two boot camps. Ten had North American general surgery training, and eleven had no pediatric surgery exposure ≥ 1 year prior. All participants expressed increased confidence with course material after boot camp [F(18,11) = 3.137;p < 0.05]. Performance improved significantly (pre- vs. posttests, 47.0% vs. 62.4%; p < 0.05). MANOVA between faculty and trainees demonstrated agreement on the value of individual sessions [F(15,3) = 0.642;p = 0.76]. Neonatal bowel obstruction, gastrostomy tube complications, esophageal atresia, pain management, and informed consent were rated most useful.ConclusionTrainees and teaching faculty considered the boot camp valuable. Trainees demonstrated significant improvements in core knowledge and confidence. The initial pediatric surgery boot camp experience shows promise in facilitating the transition to discipline for new trainees.Study typeProspective treatment study.Level of evidenceIV.     

Prope tolerance--the future of organ transplantation from the laboratory to the clinic

This is a short review of tolerance from the point of view of the clinician. Various examples of tolerance occurring in patients and animal models that relate to the clinical experience are described. It is suggested that there may be different mechanisms by which tolerance is achieved, but from the patient's point of view operational tolerance is the goal whereby, after a short induction procedure, the patient will maintain good function in the grafted organ indefinitely without maintenance immunosuppression. It is pointed out that such a goal may be difficult to achieve with any given protocol due to the enormous variation between donors and recipients of organ grafts of tissue matching, innate immune reactivity and susceptibility to disturbance of a tolerant state by infections or allergic reactions. Thus, the case is made for prope or almost tolerance in which graft acceptance is maintained by a low, non-toxic dosage of maintenance immunosuppression, which may not be required indefinitely.     

The operating room of the future: a view from Europe

The Operating Room of the Future will be characterized by meticulous preoperative planning, full integration of the operating room into the general flow of information, more comprehensive intraoperative diagnostic imaging procedures, and the use of sophisticated visualization processes including augmented reality. Mechatronic support (partially autonomous robots) enhances safety and allows reduction of staff. Integrated operating room systems will allow the wide spectrum of new devices and functionalities to be easily controlled by the operating team. The Operating Room of the Future will no longer be isolated from the rest of the clinical endeavor. Intraoperative teleconsultation and telepresence will help to promote and teach safer evidence-based endoscopic therapeutic surgery. Traditional surgical intervention will expand its definitions by procedures via an interdisciplinary, cooperative approach that will replace the sequential therapeutic process of today.     

Sex-based centers of care: a look to the future

Although sex-based centers of care have played a critical historic role in improving the health of their constituents and drawing attention to the different health care needs of men and women, it is time to challenge them to do an even better job. There are now overwhelming data showing that men and women are profoundly different at the molecular and cellular level in virtually all aspects of musculoskeletal health and disease, but the clinical implications of these differences have generally been unexplored. Sex-based health centers of care can play a critical role in exploring these difference, and, in doing so, reduce disability and enhance quality of life in our growing population of senior men and women.     

Contemporary psychosurgery and a look to the future.

OBJECT: Despite a long and controversial history, psychosurgery has persisted as a modern treatment option for some severe, medically intractable psychiatric disorders. The goal of this study was to review the current state of psychosurgery. METHODS: In this review, the definition of psychosurgery, patient selection criteria, and anatomical and physiological rationales for cingulotomy, subcaudate tractotomy, anterior capsulotomy, and limbic leukotomy are discussed. The historical developments, modern procedures, and results of these four contemporary psychosurgical procedures are also reviewed. Examples of recent advances in neuroscience indicating a future role for neurosurgical intervention for psychiatric disease are also mentioned. CONCLUSIONS: A thorough understanding of contemporary psychosurgery will help neurosurgeons and other physicians face the ethical, social, and technical challenges that are sure to lie ahead as modern science continues to unlock the secrets of the mind and brain.