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https://www.readbyqxmd.com/read/27907982/learners-perspective-where-and-when-pre-residency-trainees-learn-more-to-achieve-their-core-clinical-competencies
#1
Eusang Ahn, Ducksun Ahn, Young-Mee Lee
PURPOSE: While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. METHODS: A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews...
December 2016: Korean Journal of Medical Education
https://www.readbyqxmd.com/read/27904844/cardiothoracic-surgical-experience-in-ghana
#2
REVIEW
Mark Tettey, Martin Tamatey, Frank Edwin
Ghana is one of the few low-to-middle-income countries in sub-Saharan Africa able to consistently sustain a cardiothoracic program with locally trained staff for more than two decades. Cardiothoracic surgery practice in Ghana started in 1964 but faltered from a combination of political and the economic problems. In 1989, Dr. Kwabena Frimpong-Boateng, a Ghanaian cardiothoracic surgeon trained in Hannover, rekindled interest in cardiothoracic surgery and in establishing a National Cardiothoracic Centre. His vision and leadership has brought cardiothoracic surgery practice in Ghana to its current high level...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27904842/the-challenges-of-cardiothoracic-surgery-practice-in-nigeria-a-12-years-institutional-experience
#3
Bode Falase, Michael Sanusi, Adeola Animasahun, Ogadinma Mgbajah, Adetinuwe Majekodunmi, Onyekwelu Nzewi, Jonathan Nwiloh, David Oke
BACKGROUND: Although the specialty of cardiothoracic surgery has been practiced in Nigeria for many years, open heart surgery (OHS) has only in the last decade become relatively more frequent, mainly through visiting foreign cardiac surgical teams. At this early phase of development it is faced with multiple challenges, especially financing and local skilled manpower for which solutions have to be identified in order to ensure sustainability and future growth. This study is aimed at highlighting these obstacles to growth of cardiothoracic surgery based on our own institutional experience at Lagos State University Teaching Hospital (LASUTH) and the current status of OHS activity in other cardiothoracic centers in Nigeria...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27901332/safety-and-efficacy-of-non-continuous-echocardiographic-guided-pericardiocentesis-a-single-center-study-of-478-patients
#4
Ilaria Battistoni, Marco Marini, Luca Angelini, Matteo Francioni, Alberto Gili, Stefano Moretti, Carlo Costantini, Christian Corinaldesi, Marica Bordicchia, Gian P Perna
BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis in Italy. The aim of the study was to evaluate safety and efficacy of pericardiocentesis, performed with non-continuous echocardiography monitoring. All the procedures performed at Department of Cardiovascular Disease, Ospedali Riuniti Ancona, from January 2001 to June 2013, were retrospectively analyzed to determine risks connected to the procedure and its success rate. Epidemiological data, procedure indications and etiology of the effusions were also recorded...
November 30, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27900333/the-effects-of-hemodynamic-changes-on-pulse-wave-velocity-in-cardiothoracic-surgical-patients
#5
Yurie Obata, Maki Mizogami, Sarabdeep Singh, Daniel Nyhan, Dan E Berkowitz, Jochen Steppan, Viachaslau Barodka
The effect of blood pressure on pulse wave velocity (PWV) is well established. However, PWV variability with acute hemodynamic changes has not been examined in the clinical setting. The aim of the present study is to investigate the effect of hemodynamic changes on PWV in patients who undergo cardiothoracic surgery. Using data from 25 patients, we determined blood pressure (BP), heart rate (HR), and the left ventricular outflow tract (LVOT) velocity-time integral. By superimposing the radial arterial waveform on the continuous wave Doppler waveform of the LVOT, obtained by transesophageal echo, we were able to determine pulse transit time and to calculate PWV, stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR)...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27895344/peri-operative-determinants-of-prolonged-cicu-stay-after-coronary-artery-bypass-graft-surgery-in-elderly-at-a-private-tertiary-care-hospital-a-case-control-study
#6
Fazal Wahab Khan, Shiraz Hashmi, Syed Saeed Naeem, Benish Fatima, Hashim Hanif, Mubashir Zareen, Saulat Hasnain Fatimi
OBJECTIVE: To explore peri-operative risk factors associated with prolonged stay in cardiac intensive care unit among patients undergoing isolated coronary artery bypass grafting. Methods: This retrospective case control study was conducted at the Aga Khan University Hospital, Karachi, comprised medical records of patients who had undergone cardiothoracic revascularisation surgery from January 2006 to December 2013. The patients were grouped into cases and controls at a ratio of 1:2 on the basis of length of stay at cardiac intensive care unit, i...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27884576/extracorporeal-life-support-for-refractory-cardiac-arrest-from-accidental-hypothermia-a-10-year-experience-in-edinburgh
#7
Maziar Khorsandi, Scott Dougherty, Neil Young, Dean Kerslake, Vincenzo Giordano, Robert Lendrum, William Walker, Vipin Zamvar, Ivan Yim, Renzo Pessotto
BACKGROUND: Cardiac arrest caused by accidental hypothermia is a rare phenomenon with a significant mortality rate if untreated. The consensus is that these patients should be rewarmed with extracorporeal life support (ECLS) with the potential for excellent survival and neurologic outcomes. However, given the lack of robust data and clinical trials, the optimal management of such patients remains elusive. OBJECTIVE: In this single-center study, we looked at the outcomes of all adult patients undergoing salvage ECLS for cardiac arrest caused by accidental hypothermia over a 10-year period from June 2006 to June 2016...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27884211/plasma-glutamine-levels-before-cardiac-surgery-are-related-to-post-surgery-infections-an-observational-study
#8
Hanneke Buter, Matty Koopmans, Ramses Kemperman, Lilian Jekel, Christiaan Boerma
BACKGROUND: A low plasma glutamine level was found in 34% of patients after elective cardiothoracic surgery. This could be a result of the inflammation caused by surgical stress or the use of extracorporeal circulation (ECC). But it is also possible that plasma glutamine levels were already lowered before surgery and reflect an impaired metabolic state and a higher likelihood to develop complications. In the present study plasma glutamine levels were measured before and after cardiac surgery and we questioned whether there is a relation between plasma glutamine levels and duration of ECC and the occurrence of postoperative infections...
November 25, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27884147/effects-of-osteopathic-treatment-on-pulmonary-function-and-chronic-thoracic-pain-after-coronary-artery-bypass-graft-surgery-ostincare-study-protocol-for-a-randomised-controlled-trial
#9
Gert Roncada
BACKGROUND: Coronary artery bypass graft surgery (CABG) is an effective and widespread coronary revascularisation technique, nevertheless there are a number of long-term postoperative complications from which patients can suffer. One year after CABG surgery pulmonary function is decreased by 12% and 30% of the patients suffer from chronic thoracic pain. To date and to our knowledge there are no effective treatments for these conditions. The aim of the present clinical trial is to explore the effectiveness of osteopathic treatment on these conditions...
November 25, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27871762/clinical-and-histopathologic-ocular-findings-in-disseminated-mycobacterium-chimaera-infection-after-cardiothoracic-surgery
#10
Sandrine A Zweifel, Daniela Mihic-Probst, Christine A Curcio, Daniel Barthelmes, Andrea Thielken, Peter M Keller, Barbara Hasse, Christian Böni
PURPOSE: To investigate and characterize clinical and histopathologic ocular findings in patients with disseminated infection with Mycobacterium chimaera, a slow-growing nontuberculous mycobacterium (NTM), subsequent to cardiothoracic surgery. DESIGN: Observational case series. PARTICIPANTS: Five white patients (10 eyes). METHODS: Analysis of clinical ocular findings, including visual acuity, slit-lamp biomicroscopy, spectral-domain optical coherence tomography (SD OCT), fundus autofluorescence (FAF), and fluorescein angiography/indocyanine green (ICG) angiography findings, of patients with a disseminated M...
November 18, 2016: Ophthalmology
https://www.readbyqxmd.com/read/27867301/perioperative-evaluation-of-patients-with-pulmonary-conditions-undergoing-non-cardiothoracic-surgery
#11
REVIEW
Gilda Diaz-Fuentes, Hafiz Rizwan Talib Hashmi, Sindhaghatta Venkatram
This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27865060/reducing-variation-in-feeding-newborns-with-congenital-heart-disease
#12
Janet M Simsic, Kirby-Rose Carpenito, Kristin Kirchner, Stephanie Peters, Holly Miller-Tate, Brian Joy, Mark Galantowicz
OBJECTIVE: Enteral feeding is associated with decreased infection rates, decreased mechanical ventilation, decreased hospital length of stay, and improved wound healing. Enteral feeding difficulties are common in congenital heart disease. Our objective was to develop experience-based newborn feeding guidelines for the initiation and advancement of enteral feeding in the cardiothoracic intensive care unit. DESIGN: This is a retrospective analysis of a quality improvement project...
November 16, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27863915/prenatal-ultrasound-monitoring-of-homozygous-%C3%AE-0-thalassemia-induced-fetal-anemia
#13
REVIEW
Helena H L Lee, Annisa S L Mak, C F Poon, K Y Leung
A noninvasive approach by serial ultrasound examination at 12-15, 18, and 30 weeks of gestation can be used to exclude homozygous α(0)-thalassemia-induced fetal anemia. At 12-15 weeks of gestation, the predictive values for the fetal cardio-thoracic ratio were better than that for the placental thickness. At 16-20 weeks of gestation, measuring middle cerebral artery peak systolic velocity is associated with a low false-positive rate. However, the false-positive rate of this noninvasive approach can be about 3%, requiring an invasive test to confirm the diagnosis...
October 26, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27862040/central-extracorporeal-life-support-with-left-ventricular-decompression-to-berlin-heart-excor-a-reliable-bridge-to-bridge-strategy-in-crash-and-burn-patients
#14
Alexander Weymann, Mina Farag, Anton Sabashnikov, Javid Fatullayev, Mohamed Zeriouh, Bastian Schmack, Rawa Arif, Florian Müller, Christina Alt, Philip Raake, Nikhil Prakash Patil, Aron-Frederik Popov, Andre Rüdiger Simon, Matthias Karck, Arjang Ruhparwar
The aim of this study was to compare patients with severe biventricular heart failure who underwent Berlin Heart Excor implantation with (cardiogenic shock [CS] status) or without the need for preoperative extracorporeal life support (ECLS) as a bridge to long-term device. A total of 40 consecutive patients with severe biventricular heart failure underwent Berlin Heart Excor implantation with (CS status, n = 20, 50%) or without (control, n = 20, 50%) the need for preoperative ECLS as a bridge to long-term device from March 2007 to May 2015 at our institution...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27858208/a-cable-driven-soft-robot-surgical-system-for-cardiothoracic-endoscopic-surgery-preclinical-tests-in-animals
#15
Hesheng Wang, Runxi Zhang, Weidong Chen, Xiaozhou Wang, Rolf Pfeifer
BACKGROUND: Minimally invasive surgery attracts more and more attention because of the advantages of minimal trauma, less bleeding and pain and low complication rate. However, minimally invasive surgery for beating hearts is still a challenge. Our goal is to develop a soft robot surgical system for single-port minimally invasive surgery on a beating heart. MATERIALS AND METHODS: The soft robot described in this paper is inspired by the octopus arm. Although the octopus arm is soft and has more degrees of freedom (DOFs), it can be controlled flexibly...
November 17, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27856076/hospital-wide-comparison-of-health-care-associated-infection-among-8-intensive-care-units-a-retrospective-analysis-for-2010-2015
#16
DongMei Yue, Caiping Song, Bo Zhang, Zhiyong Liu, Jin Chai, Yang Luo, Hao Wu
BACKGROUND: Exploring the distribution of nosocomial pathogens among different categories of intensive care units (ICUs) is critical to improving the management of health care-associated infection (HAI). Despite both single- and multicenter studies, the nature of the variations of HAIs within various ICUs remains inadequately evaluated. METHODS: Data on HAIs at our hospital during the period January 2010-December 2015 were collected from 8 ICUs, namely, respiratory, cardiovascular, neurology, neonatal, hematology, emergency, cardiothoracic surgery, and neurosurgery ICUs, at a tertiary hospital...
November 14, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27854541/what-exactly-is-a-centrally-located-lung-tumor-results-of-an-on-line-survey
#17
Roberto F Casal, Macarena R Vial, Russell Miller, Lakshmi Mudambi, Horiana B Grosu, George A Eapen, Carlos A Jimenez, Rodolfo C Morice, Lorraine Cornwell, David Ost
RATIONALE: Accurate mediastinal staging is cornerstone in the management of patients with lung cancer. For patients with radiographically normal mediastinum, current lung cancer guidelines recommend invasive mediastinal staging when tumors are centrally located. However, definitions of central tumors are non-specific and there are discrepancies among guidelines (e.g. some use the inner one third of the hemithorax while others use the inner two thirds). OBJECTIVES: To describe the definitions of central tumors used by pulmonologists and thoracic surgeons in their practice...
November 17, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27850552/914-the-efficacy-and-safety-of-proton-pump-inhibitor-use-in-cardiothoracic-surgery-patients
#18
Marissa Hom, Jennifer Mai, Andrea Nigg, John MacKay
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850517/879-comparison-of-aerosolized-epoprostenol-formulations-in-the-cardiothoracic-surgery-population
#19
Danielle Evans, Alexander Ulici, Andrew Tom, Natasha Lopez
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849808/165-fluid-overload-after-pediatric-cardiothoracic-surgery-is-associated-with-surgical-site-infection
#20
Anthony Sochet, Aoibhinn Nyhan, Michael Spaeder, Xiaoyan Song, Darren Klugman, Anna Brown
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
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