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https://www.readbyqxmd.com/read/29684925/minimally-invasive-resection-of-deep-seated-high-grade-gliomas-using-tubular-retractors-and-exoscopic-visualization
#1
Rajiv Iyer, Kaisorn L Chaichana
BACKGROUND AND STUDY AIMS/OBJECTIVE:  Deep-seated high-grade gliomas (HGGs) represent a unique surgical challenge because they reside deep to critical cortical and subcortical structures and infiltrate functional areas of the brain. Therefore, accessing and resecting these tumors can often be challenging and associated with significant morbidity. We describe the use of minimally invasive approaches to access deep-seated HGGs to achieve extensive resections while minimizing surgical morbidity...
April 23, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29684373/racial-disparity-in-utilization-of-high-volume-hospitals-for-surgical-treatment-of-esophageal-cancer
#2
Sadiq S Rehmani, Bian Liu, Adnan Al-Ayoubi, Wissam Raad, Raja M Flores, Faiz Bhora, Emanuela Taioli
BACKGROUND: Utilization of high-volume hospitals (HVH) for esophagectomy has been associated with improved perioperative outcomes and reduced mortality. We aimed to test the hypothesis that black-white racial disparities exist in HVH utilization, and to identify predictors of in-hospital surgical outcomes of esophageal cancer while adjusting for HVH utilization patterns. METHODS: We queried the New York Statewide Planning and Research Cooperative System (SPARCS) database (1995-2012) for esophageal cancer patients who underwent surgical resection exclusively...
April 20, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29681553/the-radicalization-of-breast-cancer-surgery-joseph-colt-bloodgood-s-role-in-william-stewart-halsted-s-legacy
#3
James R Wright
Johns Hopkins's surgeon William Stewart Halsted is renowned for popularizing the radical mastectomy, a disfiguring procedure that was overutilized during the 1900s. Cancer historians have questioned why Halsted, a meticulous surgical investigator, became more aggressive in his approach to breast cancer surgery when his own data failed to show prolonged patient survival. Joseph Colt Bloodgood, one of Halsted's early surgical residents, Hopkins's head of surgical pathology, and Halsted's primary outcome data analyst, played previously unrecognized roles...
2018: Bulletin of the History of Medicine
https://www.readbyqxmd.com/read/29678532/feasibility-and-benefit-of-incorporating-a-multimedia-cadaver-laboratory-training-program-into-a-didactics-curriculum-for-junior-and-senior-surgical-residents
#4
Erika Simmerman, Andrew Simmerman, Randi Lassiter, Ray King, Ben Ham, Bao-Ling Adam, Colville Ferdinand, Steven Holsten
OBJECTIVE: As operative experience in general surgery decreases and work hour limitations increase there is less exposure of surgical residents to advanced vascular and trauma exposures. Many institutions have demonstrated benefits of cadaver laboratory courses. We have incorporated a multimedia cadaver laboratory course into our general surgery residency didactics curriculum with the objective to demonstrate a benefit of the program as well as the feasibility of incorporation. STUDY DESIGN: This is a prospective study at a tertiary care institution including general surgery residents within our residency program...
April 17, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29674110/resident-specific-morbidity-reduced-following-acs-nsqip-data-driven-quality-program
#5
Florence E Turrentine, John B Hanks, Megan C Tracci, R Scott Jones, Bruce D Schirmer, Philip W Smith
BACKGROUND: The Accreditation Council for Graduate Medical Education Milestone Project for general surgery provided a more robust method for developing and tracking residents' competence. This framework enhanced systematic and progressive development of residents' competencies in surgical quality improvement. STUDY DESIGN: A 22-month interactive, educational program based on resident-specific surgical outcomes data culminated in a quality improvement project for postgraduate year 4 surgery residents...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29674109/mixed-method-evaluation-of-a-cadaver-dissection-course-for-general-surgery-interns-an-innovative-approach-for-filling-the-gap-between-gross-anatomy-and-the-operating-room
#6
Yen-Yi Juo, Christina Hanna, Quach Chi, Grace Chang, Warwick J Peacock, Areti Tillou, Catherine E Lewis
OBJECTIVE: To evaluate an innovative whole cadaver dissection curriculum designed to focus on teaching procedure-relevant anatomy and surgical skills to surgery interns. DESIGN: A mixed methods explanatory sequential design incorporating both quantitative and qualitative evaluations was used to evaluate the cadaver dissection course. Quantitative data were prospectively collected and retrospectively reviewed in order to compare anatomy knowledge and operative skills before and after the course...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29674108/the-effects-of-feedback-fatigue-and-sex-disparities-in-medical-student-feedback-assessed-using-a-minute-feedback-system
#7
Meredith Barrett, Patrick Georgoff, Niki Matusko, Lisa Leininger, Rishindra M Reddy, Gurjit Sandhu, David T Hughes
OBJECTIVE: Feedback is critical to the development of medical students. To enhance feedback, we created a web application, the Minute Feedback System (MFS). This app allows students to request precise, timely, written feedback from residents and staff without the burden of vague, end-of-rotation surveys. In this study, we investigate variations in response rates and feedback fatigue based on sex and rank (resident/fellow vs. faculty). DESIGN: Data were collected from May 2015-October 2016...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29674107/the-economics-of-private-practice-versus-academia-in-surgery
#8
Maria Baimas-George, Brian Fleischer, James R Korndorffer, Douglas Slakey, Christopher DuCoin
OBJECTIVE: Residents often make career decisions regarding future practice without adequate knowledge to the realities of professional life. Currently there is a paucity of data regarding economic differences between practice models. This study seeks to illuminate the financial differences of surgical subspecialties between academic and private practice. DESIGN: Data were collected from the Association of American Medical College (AAMC) and the Medical Group Management Association's (MGMA) 2015 reports of average annual salaries...
April 16, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29671727/how-should-trainee-autonomy-and-oversight-be-managed-in-the-setting-of-overlapping-surgery
#9
Jean-Nicolas Gallant, Alexander Langerman
This case highlights an attending surgeon's conflicts between duty to care for individual patients, train independent surgeons, and serve a patient population in an efficient manner. Although oversight of surgical residents and multiple operating room scenarios can be conducted in an ethical manner, patients might not understand the realities of surgical training and clinical logistics without explicit disclosure. Central to the ethical concerns of the case are the attending surgeon's obfuscation of resident involvement and her insufficient oversight of two concurrent procedures...
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29670888/computational-fluid-dynamic-analysis-of-the-left-atrial-appendage-to-predict-thrombosis-risk
#10
Giorgia Maria Bosi, Andrew Cook, Rajan Rai, Leon J Menezes, Silvia Schievano, Ryo Torii, Gaetano Burriesci
During Atrial Fibrillation (AF) more than 90% of the left atrial thrombi responsible for thromboembolic events originate in the left atrial appendage (LAA), a complex small sac protruding from the left atrium (LA). Current available treatments to prevent thromboembolic events are oral anticoagulation, surgical LAA exclusion, or percutaneous LAA occlusion. However, the mechanism behind thrombus formation in the LAA is poorly understood. The aim of this work is to analyse the hemodynamic behaviour in four typical LAA morphologies - "Chicken wing", "Cactus", "Windsock" and "Cauliflower" - to identify potential relationships between the different shapes and the risk of thrombotic events...
2018: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29670222/stem-cells-in-middle-ear-cholesteatoma-contribute-to-its-pathogenesis
#11
Julia Nagel, Saskia Wöllner, Matthias Schürmann, Viktoria Brotzmann, Janine Müller, Johannes Fw Greiner, Peter Goon, Barbara Kaltschmidt, Christian Kaltschmidt, Holger Sudhoff
Cholesteatoma is a potentially life-threatening middle ear lesion due to the formation of an inflamed ectopic mass of keratinizing squamous epithelium. Surgical removal remains the only treatment option, emphasizing the need to gain a better understanding of this severe disease. We show for the first time that stem cells residing in cholesteatoma tissue contribute to disease progression. Cells expressing the "stemness" markers Nestin and S100B were detected in middle ear cholesteatoma and auditory canal skin...
April 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29667041/perception-versus-reality-elucidating-motivation-and-expectations-of-current-fellowship-council-minimally-invasive-surgery-fellows
#12
Jeffrey R Watkins, Aurora D Pryor, Michael S Truitt, D Rohan Jeyarajah
BACKGROUND: The aim of our study is to determine minimally invasive trainee motivation and expectations for their respective fellowship. Minimally Invasive Surgery (MIS) is one of the largest non-ACGME post-residency training pathways though little is known concerning the process of residents choosing MIS as a fellowship focus. As general surgery evolves, it is important to understand resident motivation in order to better prepare them for a surgical career. METHODS: A survey invitation was sent to current trainees in the Minimally Invasive and related pathways through the Fellowship Council...
April 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29666797/development-and-implementation-of-a-perianesthetic-safety-checklist-in-a-veterinary-university-small-animal-teaching-hospital
#13
Gwennaëlle Menoud, Shannon Axiak Flammer, Claudia Spadavecchia, Mathieu Raillard
Introduction: The use of a surgical safety checklist is recommended by the World Health Organization and is associated with advantages: improved communication and reduced complications and mortality. Adapting checklists to the environment in which they are used improves their efficiency, but their implementation can be challenging. The aim of this study was to develop and implement a perianesthetic safety checklist for a small animal hospital. Materials and methods: A panel of eight anesthesia diplomates and seven residents and doctoral students were gathered...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29666072/left-ventricular-assist-device-inflow-cannula-angle-and-thrombosis-risk
#14
Venkat Keshav Chivukula, Jennifer A Beckman, Anthony R Prisco, Todd Dardas, Shin Lin, Jason W Smith, Nahush A Mokadam, Alberto Aliseda, Claudius Mahr
BACKGROUND: As heart failure prevalence continues to increase in the setting of a static donor supply, left ventricular assist device (LVAD) therapy for end-stage heart failure continues to grow. Anecdotal evidence suggests that malalignment of the LVAD inflow cannula may increase thrombosis risk, but this effect has not been explored mechanistically or quantified statistically. Our objective is to elucidate the impact of surgical angulation of the inflow cannula on thrombogenicity. METHODS AND RESULTS: Unsteady computational fluid dynamics is used in conjunction with computational modeling and virtual surgery to model flow through the left ventricle for 5 different inflow cannula angulations...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#15
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29664699/diversity-in-otolaryngology-residency-programs-a-survey-of-otolaryngology-program-directors
#16
Hillary Newsome, Erynne Faucett, Thomas Chelius, Valerie Flanary
Objective As the population of the United States becomes increasingly racially and ethnically diverse, it is important that the medical profession reflect these changes. Otolaryngology has previously been identified as one of the surgical subspecialties with the smallest presence of those underrepresented in medicine. In the context of this study, the term underrepresented in medicine is defined as blacks, Latinos, Native American, and Native Hawaiians. The purpose of this study was to describe the current state of otolaryngology residency programs in terms of diversity of resident and faculty cohort, explore general interviewing practices, and investigate recruitment of underrepresented in medicine applicants...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29663311/interobserver-variability-in-the-classification-of-appendicitis-during-laparoscopy
#17
A L van den Boom, E M L de Wijkerslooth, K A L Mauff, I Dawson, C C van Rossem, B R Toorenvliet, B P L Wijnhoven
BACKGROUND: The intraoperative classification of appendicitis dictates the patient's postoperative management. Prolonged antibiotic prophylaxis is recommended for complex appendicitis (gangrenous, perforated, abscess), whereas preoperative prophylaxis suffices for simple appendicitis. Distinguishing these two conditions can be challenging. The aim of this study was to assess interobserver variability in the classification of appendicitis during laparoscopy. METHODS: Short video recordings taken during laparoscopy for suspected appendicitis were shown to surgeons and surgical residents...
April 16, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29661505/training-cardiothoracic-surgeons-of-the-future-the-uk-experience
#18
Louise Kenny, Karen Booth, Kathrin Freystaetter, Greta Wood, Gary Reynolds, Sridhar Rathinam, Narain Moorjani
OBJECTIVE: The study aimed to assess targeted simulation courses, including live animal operating, as complementary training tools with regard to 2 key surgical skills in early cardiothoracic surgeon training. METHODS: Twenty UK surgical trainees (equivalent to cardiothoracic surgery resident physicians in the United States) in their first year of residency training were evaluated. Assessment of skills in pulmonary wedge resection and cardiopulmonary bypass were undertaken before and after 2 boot camp-style courses, including live animal operating (boot camp 1 and boot camp 2)...
February 15, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29656619/impact-of-resident-involvement-in-neurosurgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-database-analysis-of-33-977-patients
#19
Andreea Seicean, Prateek Kumar, Sinziana Seicean, Duncan Neuhauser, Warren R Selman, Nicholas C Bambakidis
OBJECTIVE: There is conflicting and limited literature on the effect of intraoperative resident involvement on surgical outcomes. Our study assessed effects of resident involvement on outcomes in patients undergoing neurosurgery. METHODS: We identified 33,977 adult neurosurgical cases from 374 hospitals in the 2006-2012 National Surgical Quality Improvement Program, a prospectively collected national database with established reproducibility and validity. Outcomes were compared according to resident involvement before and after 1:1 matching on procedure and perioperative risk factors...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29655883/evaluating-surgical-coaching-a-mixed-methods-approach-reveals-more-than-surveys-alone
#20
Laura M Mazer, Yue-Yung Hu, Alexander F Arriaga, Caprice C Greenberg, Stuart R Lipsitz, Atul A Gawande, Douglas S Smink, Steven J Yule
OBJECTIVE: Traditionally, surgical educators have relied upon participant survey data for the evaluation of educational interventions. However, the ability of such subjective data to completely evaluate an intervention is limited. Our objective was to compare resident and attending surgeons' self-assessments of coaching sessions from surveys with independent observations from analysis of intraoperative and postoperative coaching transcripts. DESIGN: Senior residents were video-recorded operating...
April 11, 2018: Journal of Surgical Education
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