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https://www.readbyqxmd.com/read/28705484/is-it-all-about-the-money-not-all-surgical-subspecialization-leads-to-higher-lifetime-revenue-when-compared-to-general-surgery
#1
Maria Baimas-George, Brian Fleischer, Douglas Slakey, Emad Kandil, James R Korndorffer, Christopher DuCoin
OBJECTIVE: It is believed that spending additional years gaining expertise in surgical subspecialization leads to higher lifetime revenue. Literature shows that more surgeons are pursuing fellowship training and dedicated research years; however, there are no data looking at the aggregate economic impact when training time is accounted for. It is hypothesized that there will be a discrepancy in lifetime income when delay to practice is considered. DESIGN: Data were collected from the Medical Group Management Association's 2015 report of average annual salaries...
July 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#2
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28441857/-clinical-exploratory-application-of-robotic-resection-of-tumor-in-segment-%C3%A2-a-report-for-7-cases
#3
Y Y Song, R Liu, G D Zhao, W B Tang, M G Hu, C G Li
Objective: To investigate the feasibility and security of robotic resection of tumor in segment Ⅷ primarily. Methods: The clinicopathologic data of 7 patients who underwent robotic resection of tumor in segment Ⅷ using daVinci robotic system in the Department of Hepato-pancreato-biliary Surgical Oncology, Chinese PLA General Hospital from June 2016 to December 2016 were retrospectively analyzed. The lesion size, the tumor malignance degree mean operation time, intraoperative blood loss and the rate of conversion to laparotomy, postoperative hospital stay, mobidity and motality of all the 7 patients were collected...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#4
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28414677/a-rare-case-of-tropical-pyomysitis-acquired-on-vacation-in-a-healthy-male
#5
K Poole, T Tran
INTRODUCTION: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. The rarity of this disease and non-specificity of its symptoms often lead to delay in appropriate diagnosis and treatment. CASE: 24-year-old man, seen 2 days prior in orthopedics clinic and the Emergency Department for persistent gluteal pain thought to be due to right-sided sciatica, was admitted following worsening pain, diffuse generalized weakness with polyarthralgias and myalgias These symptoms were associated with night sweats, shaking chills, and difficulty walking...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#6
W Nussbaumer, M Amato, H Schennach, M Astl, C Y Chen, J-S Lin, L Corash, R J Benjamin
BACKGROUND: Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients. METHODS: Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation...
April 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/27811349/prevalence-and-characteristics-of-surgical-site-infections-caused-by-gram-negative-rod-shaped-bacteria-from-the-family-enterobacteriacae-and-gram-positive-cocci-from-the-genus-staphylococcus-in-patients-who-underwent-surgical-procedures-on-selected-surgical
#7
Małgorzata Tomaszewska-Kowalska, Krzysztof Kołomecki, Maria Wieloch-Torzecka
Surgical site infections on surgical wards are the most common cause of postoperative complications. Prevalence of surgical site infections depends on the surgical specialization. Analysis of the causes of surgical site infections allows to conclude that microorganisms from the patient's own microbiota - Gram-negative rod-shaped bacteria from the family Enterobacteriacae and from the patient's skin microbiota - Gram-positive cocci - Staphylococcus are the most common agents inducing surgical site infections...
October 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/27516036/the-interdisciplinary-approach-of-an-aggressive-giant-cell-tumor-of-bone-complicated-with-a-fracture-of-the-distal-femur
#8
Iulian Daniel Vîlcioiu, Dragoş George Zamfirescu, Ioan Cristescu, Andrei Ursache, Şerban Arghir Popescu, Cosmin Antoniu Creangă, Ioan Lascăr
Giant cell tumor of bone (GCTB) represents one of the commonest bone tumors encountered by an orthopedic surgeon. The giant-cell tumor is generally classified as benign but the fast growing rhythm and the aggressive soft-tissue invasion may in some cases demonstrate a malign potential of the tumor. We present the case of an aggressive giant cell tumor in a young patient that was first diagnosed in our emergency department with a fracture of the distal femur after a low energy trauma. With further examinations, we discovered that the tumor was invading the both femoral condyles and was vascularized by three major arterial pedicles...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27211878/repaying-in-kind-examination-of-the-reciprocity-effect-in-faculty-and-resident-evaluations
#9
REVIEW
Aimee K Gardner, Daniel J Scott
BACKGROUND: Although the reciprocity hypothesis (that trainees have a tendency to modify evaluations based on the grades they receive from instructors) has been documented in other fields, very little work has examined this phenomenon in the surgical residency environment. The purpose of this study was to investigate the extent to which lenient-grading faculty receive higher evaluations from surgery residents. METHODS: Evaluation data from 2 consecutive academic years were collected retrospectively at a large university-based General Surgery residency program...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/26806975/publication-trend-in-the-indian-journal-of-orthopaedics-what-is-published-and-why
#10
Rishiram Poudel, Venkatesan Sampath Kumar, Ashok Kumar, Shah Alam Khan
BACKGROUND: Factors influencing publication of manuscripts in reputed journals have never been studied to the best of our knowledge. This study was conducted to evaluate the trend in publication within the Indian Journal of Orthopaedics (IJO). MATERIALS AND METHODS: A cross-sectional study was conducted by accessing the online database of the IJO. All the issues available online were included. Published articles were classified into one of the following thirteen categories: (i) Basic Sciences (ii) trauma (upper limb and lower limb) (iii) infections (iv) pediatric orthopedics (v) arthroplasty (vi) arthroscopy (vii) spine surgery (viii) musculoskeletal oncology (ix) hand and microvascular surgery (x) adult reconstruction (including the Ilizarov technique) (xi) general orthopedics and miscellaneous (xii) letter to editor (xiii) book review...
November 2015: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/26663761/defining-the-publication-source-of-high-quality-evidence-in-urology-an-analysis-of-evidenceupdates
#11
REVIEW
Vikram M Narayan, Kristin Chrouser, Robert B Haynes, Rick Parrish, Philipp Dahm
OBJECTIVES: To determine the publication sources of urology articles within EvidenceUpdates, a second-order peer review system of the medical literature designed to identify high-quality articles to support up-to-date and evidence-based clinical decisions. MATERIALS AND METHODS: Using administrator-level access, all EvidenceUpdates citations from 2005 to 2014 were downloaded from the topics 'Surgery-Urology' and 'Oncology-Genitourinary'. Data fields accessed included PubMed unique reference identifier, study title, abstract, journal and date of publication, as well as clinical relevance and newsworthiness ratings as determined by discipline-specific physician raters...
June 2016: BJU International
https://www.readbyqxmd.com/read/25937600/incidence-and-outcomes-of-intraoperative-vascular-surgery-consultations
#12
Rachel C Danczyk, Jake Coleman, Jordan Allensworth, Amir F Azarbal, Erica L Mitchell, Timothy K Liem, Gregory J Landry, Gregory L Moneta
OBJECTIVE: Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified, and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital-based surgical programs. This study reviewed intraoperative consultations by vascular surgeons to support other surgical services. METHODS: Intraoperative vascular consultations were reviewed from January 2006 to January 2014 for consulting service, indication, and whether consultation occurred with advanced notice...
July 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/25224820/how-much-tumor-surgery-do-early-career-orthopaedic-oncologists-perform
#13
Benjamin J Miller, Rajiv Rajani, Lee Leddy, Emily E Carmody Soni, Jeremy R White
BACKGROUND: There are few data on the types of procedures orthopaedic oncologists perform in their first years of practice. Because fellowships are graduating fellows each year and the number of tumor patients is limited, defining the practice patterns of early-career orthopaedic oncologists may help diminish early employment discontent and enhance workforce discussions. QUESTIONS/PURPOSES: The aim of the study was to use the objective case log volumes of a cross-section of early career orthopaedic oncologists to describe (1) the number of operations performed annually; (2) the proportion of tumor, trauma, adult reconstruction, and other operations for individual participants, (3) individual practice characteristics that were associated with the number of tumor procedures; and (4) the sources of satisfaction and challenges in each individual's career and surgical practice...
February 2015: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/25039983/titanium-mesh-in-the-reconstruction-of-a-malar-defect-a-case-report
#14
António Fernandes Massa, Mercedes Otero-Rivas, Manuel Ángel Rodríguez-Prieto
BACKGROUND: Increasing rates of non-melanoma skin cancer support the use of prosthetic materials for the closure of post-surgical defects with cartilage or bone involvement. The use of allografts, especially titanium, is well established in maxillofacial procedures but is uncommon in dermatologic surgery. METHODS: A 92-year-old man presented with a basal cell carcinoma measuring 2×3 cm on the right cheek. Computed tomography showed infiltration of the anterior maxillary sinus wall...
October 2014: International Journal of Dermatology
https://www.readbyqxmd.com/read/24885132/evaluating-the-optimal-timing-of-surgical-antimicrobial-prophylaxis-study-protocol-for-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Edin Mujagic, Tibor Zwimpfer, Walter R Marti, Marcel Zwahlen, Henry Hoffmann, Christoph Kindler, Christoph Fux, Heidi Misteli, Lukas Iselin, Andrea Kopp Lugli, Christian A Nebiker, Urs von Holzen, Fabrizio Vinzens, Marco von Strauss, Stefan Reck, Marko Kraljević, Andreas F Widmer, Daniel Oertli, Rachel Rosenthal, Walter P Weber
BACKGROUND: Surgical site infections are the most common hospital-acquired infections among surgical patients. The administration of surgical antimicrobial prophylaxis reduces the risk of surgical site infections . The optimal timing of this procedure is still a matter of debate. While most studies suggest that it should be given as close to the incision time as possible, others conclude that this may be too late for optimal prevention of surgical site infections. A large observational study suggests that surgical antimicrobial prophylaxis should be administered 74 to 30 minutes before surgery...
May 24, 2014: Trials
https://www.readbyqxmd.com/read/24876729/single-incision-laparoscopic-colorectal-surgery-for-cancer-state-of-art
#16
REVIEW
Fabio Cianchi, Fabio Staderini, Benedetta Badii
A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive surgery. During the last years, a great effort has been made to research for minimizing parietal trauma, yet for cosmetic reasons and in order to further reduce surgery-related pain and morbidity. New techniques, such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy (SIL) have been developed in order to reach the goal of "scarless" surgery...
May 28, 2014: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/24867735/the-differential-impact-of-plastic-surgery-subspecialties-on-the-financial-performance-of-an-academic-clinical-practice
#17
Albert H Chao, Ibrahim Khansa, Christopher Kaiser, Julian Bell, Michael J Miller
BACKGROUND: In an academic center, plastic surgery provides multiple important and distinct services. Limited data exist on how each service affects a department clinically and financially. METHODS: All new patient consultations and surgical cases between 2004 and 2012 were reviewed. Conversion rates from consultation to surgery and relative value units were calculated. Professional and facility revenues, costs, and net income were ascertained. These measures were compared between different subspecialties...
June 2014: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/24806394/management-of-metastatic-spinal-cord-compression-awareness-of-nice-guidance
#18
F M Brooks, Ameet Ghatahora, M C Brooks, Hazel Warren, Laura Price, Pranter Brahmabhatt, Saik De Vauvert, Cerys John, Elizabeth Farnworth, Erwina Sulaiman, Sashin Ahuja
OBJECTIVE: The spine is the most common site for bony metastases. It can lead to the development of significant complications and morbidity if appropriate treatment is not provided. National Institute for Health and Clinical Excellence (NICE) issued new guidance in 2008 with regard to the management of patient with metastatic spinal cord compression (MSCC) to assess the awareness of the NICE guidelines for MSCC. METHODS: We contacted doctors in oncology, trauma and orthopaedics, palliative care and general medicine and assessed their knowledge of MSCC using a questionnaire based on the salient points of the NICE guidance...
July 2014: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/24292633/microfluidic-evaluation-of-red-cells-collected-and-stored-in-modified-processing-solutions-used-in-blood-banking
#19
Yimeng Wang, Adam Giebink, Dana M Spence
The most recent American Association of Blood Banks survey found that 40,000 units of blood are required daily for general medicine, hematology/oncology, surgery, and for accident and trauma victims. While blood transfusions are an extremely important component of critical healthcare, complications associated with transfusion of blood components still exist. It is well-established that the red blood cell (RBC) undergoes many physical and chemical changes during storage. Increased oxidative stress, formation of advanced glycation endproducts, and microparticle formation are all known to occur during RBC storage...
January 2014: Integrative Biology: Quantitative Biosciences From Nano to Macro
https://www.readbyqxmd.com/read/24165333/reconstruction-of-perineal-defects
#20
REVIEW
M Mughal, R J Baker, A Muneer, A Mosahebi
INTRODUCTION: Perineal defects are commonly encountered in an oncological setting although they may also present as a result of trauma and infection (eg following Fournier's gangrene). Reconstruction of these poses functional as well as aesthetic challenges. Skin coverage and tissue volume may both be required in addition to anogenital preservation or reconstruction. General prerequisites of an adequate reconstruction of perineal defects include provision of skin cover, well vascularised tissue to fill the dead space (reducing fluid collection and infection), vulvovaginal reconstruction and no faecal or urinary contamination...
November 2013: Annals of the Royal College of Surgeons of England
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