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Dr. Davy is the Honorary President International Union of Phlebology, Honorary President French Society of Phlebology, Honorary President European Society of Phlebectomy. Dr. Andre Davy was born in 1924 in Basse, Normandy. I met Dr. Davy in 1967 in a World Congress of Phlebology in Amsterdam. I was so impressed with his skills and knowledge that when he later on proposed to be associated in the practice of phlebology, I accepted immediately. That lead to a very long medical and surgical partnership. He was an expert in the Muller phlebectomy and was also interested in chronic venous insufficiency, chronic stasis ulcer and lymphedema. He promoted sclerotherapy as part of the overall treatment of venous disease. In the early seventies, he started a training program that included not only theoretical but also practical knowledge of phlebology. In 1974 he published a book entitled, "Les Varices." He organized the first Franco-British Symposium of Phlebology that was held in Touquet in May 1981. That symposium was a complete success. It was immediately followed by a second Franco-British symposium and later on by the creation of the Venous Forum of the Royal Society of Medicine, the birth of the English journal "Phlebology," the North American Society of Phlebology, and the American Venous Forum. Later, he became Editor in Chief of Phlebologie, the journal of the French Society of Phlebology. He was named President of the French Society of Phlebology in 1986 and in 1989 President of the International Union of Phlebology. This very well educated and calm gentleman with a very outward tranquil appearance and great strength of character has always held strong opinions. He is now retired at his family home in Pont L'Eveque, France and spends his time reading, listening to the music of his favorite composers Verdi and Mahler, continuously visiting old friends such as Jean Van der Stricht, Robert Muller, Claude Gillot, and still remaining very close to his family. PAUL OUVRY, MD France
In 1844 the society of obstetrics in Berlin was founded by Carl Mayer (1795-1868). In 1873 this society splits in the society of obstetrics and the society of gynaecology. The present paper demonstrate the biography of Eduard Arnold Martin (1809-1875), the founder of the gynaecological society in Berlin (1873) and also his importance in the creation of an modern gynaecology.
The Canadian Cardiovascular Society and the Canadian Thoracic Society requested a position statement on pulmonary arterial hypertension from leading Canadian experts. The present document is intended to act as an update for the clinician, to provide a template for the initial evaluation of patients, to enable understanding of current therapeutic paradigms based on approved indications for Canada, to highlight new therapies on the horizon, and to state the positions of the Canadian Cardiovascular Society and the Canadian Thoracic Society on resource management for pulmonary arterial hypertension in Canada.
Neuroendovascular surgery/interventional neuroradiology is a relatively new subspecialty that has been evolving since the mid-1970s. During the last 2 decades, significant advances have been made in this field of minimally invasive therapy for the treatment of intracranial cerebral aneurysms; acute stroke therapy intervention; cerebral arteriovenous malformations; carotid-cavernous sinus fistulae; head, neck, and spinal cord vascular lesions; and other complex cerebrovascular diseases. Advanced postresidency fellowship programs have now been established in North America, Europe, and Japan, specifically for training in this new subspecialty. During a period of 14 years, from 1986 to the present, an ad hoc committee comprising senior executive committee members of the American Society of Interventional and Therapeutic Neuroradiology, the Joint Section of Cerebrovascular Neurosurgery, and the American Society of Neuroradiology met to establish general guidelines that were mutually agreeable to both societies for training physicians in this field. These training standard guidelines were unanimously endorsed by the Executive Committee of the Joint Section of Cerebrovascular Neurosurgery in April 1999, by the Executive Committee of the American Society of Interventional and Therapeutic Neuroradiology and the American Society of Neuroradiology in May 1999, and by the Executive Council of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons in June 1999. The guidelines for residency/ fellowship education have now been endorsed by the parent organizations of both the interventional and diagnostic neuroradiology communities, as well as both senior organizations representing neurosurgery in North America. These guidelines for training should be used as a reference and guide by any institution establishing a training program in neuroendovascular surgery/interventional neuroradiology.
Patients with resected colorectal cancer are at risk for recurrent cancer and metachronous neoplasms in the colon. This joint update of guidelines by the American Cancer Society and the US Multi-Society Task Force on Colorectal Cancer addresses only the use of endoscopy in the surveillance of these patients. Patients with endoscopically resected Stage I colorectal cancer, surgically resected Stages II and III cancers, and Stage IV cancer resected for cure (isolated hepatic or pulmonary metastasis) are candidates for endoscopic surveillance. The colorectum should be carefully cleared of synchronous neoplasia in the perioperative period. In nonobstructed colons, colonoscopy should be performed preoperatively. In obstructed colons, double-contrast barium enema or computed tomography colonography should be performed preoperatively, and colonoscopy should be performed 3 to 6 months after surgery. These steps complete the process of clearing synchronous disease. After clearing for synchronous disease, another colonoscopy should be performed in 1 year to look for metachronous lesions. This recommendation is based on reports of a high incidence of apparently metachronous second cancers in the first 2 years after resection. If the examination at 1 year is normal, then the interval before the next subsequent examination should be 3 years. If that examination is normal, then the interval before the next subsequent examination should be 5 years. Shorter intervals may be indicated by associated adenoma findings (see "Guidelines for Colonoscopy Surveillance After Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society"). Shorter intervals also are indicated if the patient's age, family history, or tumor testing indicate definite or probable hereditary nonpolyposis colorectal cancer. Patients undergoing low anterior resection of rectal cancer generally have higher rates of local cancer recurrence compared with those with colon cancer. Although effectiveness is not proven, performance of endoscopic ultrasound or flexible sigmoidoscopy at 3- to 6-month intervals for the first 2 years after resection can be considered for the purpose of detecting a surgically curable recurrence of the original rectal cancer.
The Canadian Cardiovascular Society and the Canadian Thoracic Society requested a position statement on pulmonary arterial hypertension from leading Canadian experts. The present document is intended to act as an update for the clinician, to provide a template for the initial evaluation of patients, to enable the understanding of current therapeutic paradigms based on approved indications for Canada, to highlight new therapies on the horizon, and to state the positions of the Canadian Cardiovascular Society and the Canadian Thoracic Society on resource management for pulmonary arterial hypertension in Canada.
With the aim of promoting progress in surgery through the friendly exchange of views and experience, the International Society of Surgery was founded in Brussels in 1902, thereby helping to overcome the narrow boundaries of that time's nationalism. At its first congress, the International Society of Surgery (ISS), otherwise known by its French name, Société Internationale de Chirurgie (SIC), already numbered 638 members, among them the most important surgeons from all over the world. Theodor Kocher (1841-1917) was the president of the first congress, held in Brussels in 1905, and was also responsible for the choice of topics. His presidential address clearly reflected the high aims the Society set for itself. Kocher's personal and professional authority, his surgical skill, which he liked so much to communicate to his colleagues, and his international thinking shaped the young Society. He remained on the international committee of the ISS until his death. Renowned surgeons from all over the globe traveled to Bern to see Kocher at work, among whom were many distinguished leaders of U.S. surgery. Thus Kocher's contribution had a great impact on the developing surgery, in particular in the United States. A short curriculum outlines the personality of this outstanding surgeon.
PURPOSE: Noninvasive tests for the evaluation of chronic venous insufficiency (CVI) include quantitative photoplethysmography (QPG), air plethysmography, and duplex ultrasonography measurement of valve closure time (VCT). These tests have been shown to accurately identify the presence of CVI, define the disease, and locate the involved segments. However, the correlation of noninvasive assessment of CVI with the clinical severity (Society for Vascular Surgery/International Society for Cardiovascular Surgery staging) has not been addressed critically. METHOD: During an 18-month period, 74 limbs were prospectively evaluated with clinical examination, air plethysmography, QPG and duplex ultrasonography. RESULTS: We studied 52 patients with a mean age of 46 years. There were 14 stage 0 limbs, 14 stage 1, 15 stage 2, and 31 stage 3. We found significant differences (p < 0.05) between normal limbs and those with CVI only by VCT and QPG. There were also marked trends toward worsening mean values for reflux (VCT, QPG, and venous filling index) and venous hypertension (residual volume fraction) between stages 0 to 1, and 1 to 2; however, there was a large degree of overlap between all groups. No test discriminated stage 2 from 3. Assessment of calf muscle pump function with ejection fraction showed no difference between any groups. CONCLUSION: The Society for Vascular Surgery/International Society for Cardiovascular Surgery criteria for CVI staging distinguishes ulcerated limbs (stage 3) from those with nonulcerating skin changes (hyperpigmentation, brawny edema, and subcutaneous fibrosis) (stage 2). However, we were not able to distinguish these groups by available noninvasive methods. This may imply that these tests are not accurate enough or that the progression from lipodermatosclerosis to frank ulceration is not accounted for by large-vessel hemodynamic changes, but rather by microcirculatory alterations.
The field of human stereotactic neurosurgery has just passed the half-century mark. Soon after its inception, the pioneers in the field began to meet to exchange information and ideas, which led to an international forum for stereotactic surgery. In 1973, the organization was expanded to form both the World Society for Stereotactic and Functional Neurosurgery, as well as the European and American Societies for Stereotactic and Functional Neurosurgery. Reviewing the programs of the meetings of those Societies permits one to review the nature of the information that was exchanged through the years, and, in doing so, to monitor the pulse of the field as it has developed. The first independent meeting of the American Society for Stereotactic and Functional Neurosurgery took place in Houston in 1980, at which there were 27 papers, 40% of which were on the newly emerging field of image-guided neurosurgery and the rest on classical functional neurosurgery. The five meetings since, occurring at approximately 4-year intervals, have documented the progress in epilepsy surgery, the reemergence of stereotactic surgery for movement disorders, the growth of stereotactic radiosurgery, and the genesis of frameless stereotactic techniques which have now become widespread.
The content of work of medical society in Vojvodina has always been primarily set by the founder with its main goal: the physicians professional and scientific specialization. In recent years there have been many socio-political, moral and social changes which have had great influence on the work of medical organizations. The poverty of the whole society, especially of the health service, has completely disabled organization of big professional meeting so that the professional activity meant mostly one-day meetings in health institutions. Although there was a threatening possibility to stop publishing the professional journal "Medical Review" after 47 years of appearing in print, today problem is solved by financial help by the government. Apart from professional work, other activities of physicians organizations are becoming important today. An appropriate attitude toward war generally speaking was declared in 1992 as an "Appeal for Peace". A request was made to distinguish profession and politics in the work of physicians so that the society acted only as a professional organization without political involvement and there is an initiative to found a medical association. Physicians gave their best in this hard situation to maintain work of the health service, but as it was not possible any more at one moment, an extra congress of physicians of Serbia was organized verifying serious consequences of war considering the health of the whole population. Society has been extremely engaged in solving numerous problems of ethics which have appeared due to war such as lack of medicines and health care materials as well as abuse of the private medical practice.
STUDY DESIGN: The faculty of the North American Spine Society and Scoliosis Research Society pedicle fixation workshop were questioned about their use of pedicle screw implants for fixation of the spine. OBJECTIVES: This study ascertained which faculty members used pedicle implants given specific clinical scenarios and analyzed the data for trends and consensus. SUMMARY OF BACKGROUND DATA: For the past 4 years, the North American Spine Society in conjunction with the Scoliosis Research Society has sponsored a course on pedicle fixation of the spine. During these courses, techniques of pedicle fixation have been discussed. The indications, however, for pedicle fixation have remained controversial, even among the course faculty. METHODS: A questionnaire was developed with 20 clinical scenarios, and the faculty were asked whether they would use pedicle implants as part of their surgical treatment. RESULTS: Thirty-eight of 45 (84%) questionnaires have been received and analyzed. For most scenarios, there was statistically significant consensus among the faculty that they would use a pedicle implant. There was statistically significant consensus that the faculty would not use pedicle implants for thoracic fractures or adolescent idiopathic scoliosis. DISCUSSION: This study is useful in assessing pedicle implant usage in our community but should not be used as a guide for their indications and contraindications.
The Serbian Medical Society was founded in Belgrade in 1872, 126 years ago. At that time, Serbia was liberated from the Ottoman domination, and was one of some thirty existing independent states gaining international recognition in 1878. In 1932 an old dream has been fulfilled--on the occasion of the 60th anniversary of the existence and activity of the Serbian Medical Society--the home of Serbian Medical Society was opened. A 30-year-long period in which the building of the Home was one of the main preoccupations and a "guiding light" of Serbian doctors thus ended. Money from charitable funds was used, which caused certain benefactors to be praised as noted personalities. Medical practice in those days was in the state of choice. There were no means for adequate treatment of certain ailments, and therapy without realistic scientific base was given, often covered by fictitious reasons. This was especially true for tuberculosis and cancer. Under the pretext of the introduction of "new therapeutical approaches" into medical practice and treatment, diverse pharmaceutical formulas were introduced without knowledge of their real effect--injections of milk, drug containing animal embrional cells and special attention was paid to transplantation of the sexual glands. The injection of "camphor oil" (5 cc) was thus "recommended, harmless but useless". The treatment of tuberculosis, which domineered the pathology of population, was very chaotic. The greatest number of drugs for "successful cure" were to be found here. Most commotion was caused by the so-called Friedman's cure for tuberculosis which was rejected only after vigorous debates. Our drug "Joannin" on the basis of "the old tuberculine" was also represented in this confusion (and Koch himself was forced to recant it). This medicament was also hailed as "successful cure". The origin of serious scientific efforts, however, are to be found around newly formed journal "Medicinski pregled", which attracted new and progressive contributors. At this time, the newly formed Ministry of Public Health started a campaign for the introduction of a modern organization of the health care and the inclusion of all population in it. However, in a country devastated by war and stricken by poverity, annomalies in the functioning of the health care existed, as financial preconditions did not exist and healt insurance was still in its infancy. This made the status of doctors difficult, causing long debates in the Serbian Medical Society and fierce criticism of the Ministry of Public Health. The responsible persons were accused of introducing and promoting communist ideas and revolution under the duise of health care for the poipulation.
BACKGROUND/AIMS: Sedation rates may vary among countries, depending on patients' and endoscopists' preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). METHODS: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives' endoscopy units. RESULTS: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders' endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available 'in most of the endoscopy units' in 46% (13/28) of the countries. Though they were available in 91% of the national representatives' endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. CONCLUSIONS: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.
In September 1985 a task group on the clinical utility of labelled antibodies was founded by the Society of Nuclear Medicine - Europe. This document was elaborated to report the aims and the programs of the group. In September 1986 the European Nuclear Medicine Society decided to participate in this initiative and a joint task group was created. INITIAL DOCUMENT: A. The aims to the Task Group are to monitor, co-ordinate and promote research and clinical application of techniques using radiolabelled antibodies in nuclear medicine. A.1. The Group should develop into a major point of reference, giving scientific and technical support to each member of the Society involved in this field. B. To pursue these purposes it will be necessary to develop the following: B.1. Criteria to evaluate the suitability of antigen-antibody systems for tumour detection and/or therapy. B.2. Criteria for quality control of radioimmunoreagents. B.3. Criteria for the prevention of adverse reactions or damage due to the reagent. B.4. Selection of suitable dosimetric methods for diagnostic or therapeutic applications. B.5. Elaboration of protocols for clinical experiments, including appropriate techniques to be applied in single cases. B.6. Organization of cooperative studies. C. The Task Group should promote: C.1. Informal meetings between the members of the Group. C.2. Workshops open to the members of the Society and other researchers. C.3. Publication of reports in appropriate journals.
Community-acquired pneumonia (CAP) is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in our knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity against Streptococcus pneumoniae has been important as well. It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Disease Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.
During 1993-2003, incidence of tuberculosis (TB) in the United States decreased 44% and is now occurring at a historic low level (14,874 cases in 2003). The Advisory Council for the Elimination of Tuberculosis has called for a renewed commitment to eliminating TB in the United States, and the Institute of Medicine has published a detailed plan for achieving that goal. In this statement, the American Thoracic Society (ATS), CDC, and the Infectious Diseases Society of America (IDSA) propose recommendations to improve the control and prevention of TB in the United States and to progress toward its elimination. This statement is one in a series issued periodically by the sponsoring organizations to guide the diagnosis, treatment, control, and prevention of TB. This statement supersedes the previous statement by ATS and CDC, which was also supported by IDSA and the American Academy of Pediatrics (AAP). This statement was drafted, after an evidence-based review of the subject, by a panel of representatives of the three sponsoring organizations. AAP, the National Tuberculosis Controllers Association, and the Canadian Thoracic Society were also represented on the panel. This statement integrates recent scientific advances with current epidemiologic data, other recent guidelines from this series, and other sources into a coherent and practical approach to the control of TB in the United States. Although drafted to apply to TB control activities in the United States, this statement might be of use in other countries in which persons with TB generally have access to medical and public health services and resources necessary to make a precise diagnosis of the disease; achieve curative medical treatment; and otherwise provide substantial science-based protection of the population against TB. This statement is aimed at all persons who advocate, plan, and work at controlling and preventing TB in the United States, including persons who formulate public health policy and make decisions about allocation of resources for disease control and health maintenance and directors and staff members of state, county, and local public health agencies throughout the United States charged with control of TB. The audience also includes the full range of medical practitioners, organizations, and institutions involved in the health care of persons in the United States who are at risk for TB.
The Committee on Workforce Issues of the Society for Vascular Surgery (SVS) and the North American Chapter, International Society for Cardiovascular Surgery (NA-ISCVS) generated data on the numbers and trends of operations performed and workforce requirements to provide surgical care of patients with vascular disease. Data for analysis were obtained from The National Center for Health Statistics-National Hospital Discharge Survey and questionnaires sent to 2732 vascular surgeons. The data showed that SVS/NA-ISCVS and regional vascular society (RVS) surgeons performed 51% of 583,000 vascular procedures undertaken in the United States in 1992. This represents a 24% increase over the 41% reported in 1985 by similarly defined surgeons. Analysis of 1992 index cases documented that SVS/NA-ISCVS and RVS surgeons accounted for 80% of 31,000 aortoiliofemoral bypasses, 68% of 46,000 aortic aneurysmectomies, 64% of 91,000 carotid endarterectomies, and 72% of 98,000 angioaccess procedures. The mean numbers of vascular operations performed in 1992 by SVS/NA-ISCVS and RVS surgeons were 144 and 100, respectively. These procedures represented 64% and 39% of the total surgical caseload of SVS/NA-ISCVS and RVS surgeons, respectively. American Board of Surgery (ABS)-certified vascular surgeons performed a mean of 171 vascular operations in 1992. Other surgeons, including ABS-certified general surgeons, appear to be performing fewer vascular operations. The latter fact and the increasing incidence of vascular disease in an expanding elderly population supports a continued need for vascular surgery specialists. Evolving technology and new health care delivery systems, however, may lessen the need for surgical care of these patients. Continued assessments of workforce activity will allow better definition of changing vascular surgery needs.