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vascular surgery; general surgery; trauma

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https://www.readbyqxmd.com/read/29121841/prophylactic-inferior-vena-cava-filter-utilization-and-risk-factors-for-nonretrieval
#1
Jordan R Stern, Danielle E Cafasso, Andrew J Meltzer, Darren B Schneider, Sharif H Ellozy, Peter H Connolly
PURPOSE: Inferior vena cava filters (IVCFs) are often placed for prophylactic indications. We sought to better define the range of practice indications for placement of prophylactic IVCFs, as well as the specific retrieval rate and risk factors for nonretrieval. METHODS: A retrospective, single-institution review of patients undergoing IVCF placement over a 2-year period was performed. Patients undergoing prophylactic IVCF placement were selected from a prospectively collected database...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29118550/-horrendoplasty-a-case-of-total-perineal-destruction-by-agricultural-implement
#2
Pedro Simoes de Oliveira, Tiago Ribeiro de Oliveira, David Martinho, Francisco Martins
Although posterior urethral injury occurs almost always in association with pelvic fracture, it may result from severe trauma to the perineum with its associated potential lethality and severe morbidity. Early primary endoscopic realignment over a urethral catheter can be attempted, although an immediate suprapubic tube placement remains the standard of care. Definitive treatment consists of elective open posterior anastomotic urethroplasty through a perineal approach. The authors present a 53-year-old man who sustained total, massive perineal destruction resulting from work accident with an agricultural implement...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29025099/dutch-surgeons-views-on-the-volume-outcome-mechanism-in-surgery-a-qualitative-interview-study
#3
R Mesman, M J Faber, G P Westert, H J J M Berden
Objective: To contribute to a better understanding of volume-outcome relationships in surgery by exploring Dutch surgeons' views on the underlying mechanism. Design: A qualitative study based on face-to-face semi structured interviews and an inductive content analysis approach. Setting: Interviews were conducted in eight hospitals in the Netherlands (2 university, 4 teaching and 2 general). Participants: Twenty surgeons (gastrointestinal, vascular and trauma)...
August 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28876577/surgical-burden-of-disease-at-a-regional-hospital-in-south-africa
#4
O Swart, J Pape, R Duvenage
BACKGROUND: There is limited published data describing the nature of surgical admissions at a regional level in the South African context. Worcester Hospital General Surgery has introduced an electronic online database to manage its surgical services. This study uses that database to evaluate the surgical burden of disease for the Cape Winelands East and Overberg districts of the Western Cape. METHOD: Admissions data were prospectively captured from February 2012 to January 2016, then retrospectively reviewed and classified into 5 types: (1) elective surgery/investigations (ESI); (2) trauma; (3) burns; (4) non-traumatic surgical emergencies (NTSE); (5) unplanned readmission within 30 days...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#5
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
October 2017: Current Opinion in Critical Care
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
#6
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/28529196/the-usage-of-mock-oral-examinations-for-program-improvement
#7
Shari L Meyerson, Stuart Lipnick, Edward Hollinger
OBJECTIVE: Mock oral examinations are often used to prepare residents for the American Board of Surgery certifying examination. Another potential use of these examinations is to identify programmatic weaknesses. Results from a multi-institutional mock oral examination were evaluated to determine if specific areas of weakness within each of the participating programs could be identified to facilitate program development. DESIGN: A mock oral examination was administered annually consisting of 3 examination rooms per resident with 3 cases in each room...
May 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28398961/accreditation-council-for-graduate-medical-education-acgme-surgery-resident-operative-logs-the-last-quarter-century
#8
COMPARATIVE STUDY
Frederick Thurston Drake, Shahram Aarabi, Brandon T Garland, Ciara R Huntington, Jarod P McAteer, Morgan K Richards, Nicole Kansier Zern, Kenneth W Gow
STUDY OBJECTIVE: To describe secular trends in operative experience for surgical trainees across an extended period using the most comprehensive data available, the Accreditation Council for Graduate Medical Education (ACGME) case logs. BACKGROUND: Some experts have expressed concern that current trainees are inadequately prepared for independent practice. One frequently mentioned factor is whether duty hours' restrictions (DHR) implemented in 2003 and 2004 contributed by reducing time spent in the operating room...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28273299/association-between-ratio-of-fresh-frozen-plasma-to-red-blood-cells-during-massive-transfusion-and-survival-among-patients-without-traumatic-injury
#9
COMPARATIVE STUDY
Tomaz Mesar, Andreas Larentzakis, Walter Dzik, Yuchiao Chang, George Velmahos, Daniel Dante Yeh
Importance: Hemostatic resuscitation has been shown to be beneficial for patients with trauma, but there is little evidence that it is equally beneficial for bleeding patients without trauma. The practice of a high transfusion ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) has spread to other surgical and medical fields. Objective: To identify whether ratio-based resuscitation in patients without trauma is associated with improved survival. Design, Setting, and Participants: This study is a retrospective review of all massive transfusions provided in an urban academic hospital from January 1, 2009, through December 31, 2012...
June 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28205467/a-rare-type-of-upper-extremity-injury-penetrating-injuries-caused-by-blunt-edged-items
#10
Hakan Şirinoğlu, Furkan Certel, Nebil Yeşïloğlu, Gökhan Temïz, Kübra Ece Kalafatlar, Murat Sarici, Özhan Çelebïler
BACKGROUND: Penetrating upper extremity injury is a common encountered cause of significant loss of labor force and it is generally caused by sharp items. This article presents five rare cases of penetrating hand and forearm injury caused by blunt-edged items in conjunction with a detailed discussion of the mechanism and management of the injury. METHODS: Five patients with a mean age of 37.6 were treated for upper extremity trauma caused by "blunt-edged items" such as corrugated iron fence, garden wires, iron stick or iron safety fence between 2009 to 2014...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#11
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/28151094/spontaneous-resolution-of-ruptured-intracranial-pial-arteriovenous-fistula-following-spinal-surgery
#12
Mark K Lyons, Joseph M Hoxworth, Jamal McClendon, Chandan X Krishna, Naresh P Patel
Pial arteriovenous fistulae (AVFs) are rare vascular abnormalities that are distinct from arteriovenous malformations and dural AVFs. These vascular lesions have been linked with trauma, ischemic syndromes, venous thrombotic diseases, and intracranial surgical procedures. In this report we describe a case of an intracranial ruptured pial AVF immediately following uneventful spinal surgery in an elderly patient with subsequent spontaneous resolution. He was a previous heavy smoker with a 60-pack-year history and alcohol abuse...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28121362/anatomy-pathophysiology-and-classification-of-posterior-tibial-tendon-dysfunction
#13
REVIEW
M Guelfi, A Pantalone, R M Mirapeix, D Vanni, F G Usuelli, M Guelfi, V Salini
OBJECTIVE: Adult acquired flatfoot deformity is generally associated with a collapsing medial longitudinal arch and a progressive loss of strength of the posterior tibial tendon (PTT). This condition is commonly associated with PTT dysfunction or rupture, which can have an arthritic or a traumatic etiology. Several causes have been proposed to explain the clinical evidence of tendon degeneration observed at the time of surgery including trauma, anatomical, mechanical, inflammatory and ischemic factors...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28045741/is-your-graduating-general-surgery-resident-qualified-to-take-trauma-call-a-15-year-appraisal-of-the-changes-in-general-surgery-education-for-trauma
#14
Aaron Strumwasser, Daniel Grabo, Kenji Inaba, Kazuhide Matsushima, Damon Clark, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Trauma training in general surgery residency is undergoing an evolution. Hour restrictions, the growth of subspecialty care, and the trend toward nonoperative management have altered resident exposure to operative trauma. We sought to identify trends in resident trauma training since the inception of the 80-hour workweek. METHODS: The Accreditation Council for General Medical Education Case Log Statistical Reports for Surgery was abstracted for general surgery resident trauma operative volume for the years 1999-2014...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27923680/the-100-most-cited-manuscripts-in-emergency-abdominal-surgery-a-bibliometric-analysis
#15
Thomas Ellul, Nicholas Bullock, Tarig Abdelrahman, Arfon G M T Powell, Jolene Witherspoon, Wyn G Lewis
BACKGROUND: The number of citations a scientific article receives provides a good indication of its impact within any given field. This bibliometric analysis aimed to identify the 100 most cited articles in Emergency Abdominal Surgery (EAS), to highlight key areas of interest and identify those that have most significantly shaped contemporary clinical practice in this newly evolving surgical specialty. This is of increasing relevance as concerns grow regarding the variable and suboptimal outcomes in Emergency General Surgery...
January 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27911067/-vascular-interventional-radiology-a-fundamental-procedure-for-the-management-of-paediatric-trauma
#16
E Bordón Cabrera, A Laín, R Gander, M Pérez Lafuente, I Díez Miranda, C G Fontecha, L Seidler, I Delgado, S Cañadas Palazón, J Lloret
INTRODUCTION: The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment. AIM: The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs. METHODS: Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
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
#17
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/27724088/advances-in-military-resuscitation
#18
Sharon Edwards, Jason Smith
Trauma is a leading cause of death and disability worldwide, in civilian environments and on the battlefield. Trauma-induced haemorrhage is the principal cause of potentially preventable death, which is generally attributable to a combination of vascular injury and coagulopathy. Survival rates following severe traumatic injury have increased due to advanced trauma management initiatives and treatment protocols, influenced by lessons learned from recent conflicts in Iraq and Afghanistan. The use of tourniquets and intraosseous needles, early blood and blood product transfusion, administration of tranexamic acid in pre-hospital settings, and consultant-led damage control resuscitation incorporating damage control surgery have all played their part...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27621021/trends-in-open-vascular-surgery-for-trauma-implications-for-the-future-of-acute-care-surgery
#19
Joseph D Forrester, Thomas G Weiser, Paul Maggio, Timothy Browder, Lakshika Tennakoon, David Spain, Kristan Staudenmayer
BACKGROUND: Trauma patients with vascular injuries have historically been within a general surgeon's operative ability. Changes in training and decline in operative trauma have decreased trainees' exposure to these injuries. We sought to determine how frequently vascular procedures are performed at US trauma centers to quantify the need for general surgeons trained to manage vascular injuries. METHODS: We conducted a retrospective analysis of the National Trauma Data Base (NTDB) from 2012 compared with 2002...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27566811/management-of-bleeding-in-vascular-surgery
#20
REVIEW
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
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