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https://www.readbyqxmd.com/read/28302349/influence-of-pathologist-experience-on-positive-surgical-margins-following-radical-prostatectomy
#1
Jacob E Tallman, Vignesh T Packiam, Kristen E Wroblewski, Gladell P Paner, Scott E Eggener
BACKGROUND: A positive surgical margin (PSM) following radical prostatectomy (RP) for prostate cancer is associated with increased risk of biochemical recurrence. We sought to examine whether the pathologist is an independent predictor of PSMs. METHODS: We performed a retrospective review of 3,557 men who underwent RP for localized prostate cancer at our institution from 2003 to 2015. We evaluated 29 separate pathologists. Univariate and multivariable logistic regression were used to test variables previously shown to influence PSM rates...
March 13, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28301364/effect-of-surgeon-volume-and-craniofacial-fellowship-training-on-cleft-palate-complication-rates
#2
Anna R Schoenbrunner, Cecilia L Dalle Ore, Samuel Lance, Joyce McIntyre, Marilyn Jones, Amanda Gosman
BACKGROUND: Both the general and pediatric surgical literature have evidenced an inverse relationship between surgical case volume and complications. This study seeks to ascertain the relationship between case volume and fistula rates in cleft palate patients. We also seek to determine if craniofacial fellowship training impacts fistula rates. METHODS: Charts were reviewed at a multidisciplinary cleft center in San Diego, CA. We performed chart review on 207 nonsyndromic patients with cleft lip and palate who had surgery at our institution from 1988 to 2010...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28295215/non-technical-skills-of-surgical-trainees-and-experienced-surgeons
#3
H Gostlow, N Marlow, M J W Thomas, P J Hewett, A Kiermeier, W Babidge, M Altree, G Pena, G Maddern
BACKGROUND: In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees...
March 13, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28292636/who-we-are-and-what-we-can-become-an-analysis-of-professional-identity-formation-in-ir
#4
Eric J Keller, Katherine A McGee, Scott A Resnick, Scott O Trerotola, Karim Valji, Matthew S Johnson, Jeremy D Collins, Robert L Vogelzang
PURPOSE: To characterize the unique experiences, values, and perspectives of interventional radiology (IR) fellows. MATERIALS AND METHODS: Sixteen fellows from 4 US vascular and IR programs were interviewed within 2 months of beginning and 2-3 months following their 2015-2016 fellowships about patient interactions, training experiences, and views of IR and other specialties. Interviews were systematically analyzed for dominant themes by using constructivist grounded theory...
March 11, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28261407/factors-influencing-residency-program-selection-by-medical-students-pursuing-obstetrics-and-gynecology
#5
Meredith J Alston, Torri D Metz, Russell Fothergill, Amy Meg Autry, Sarah A Wagner, Amanda A Allshouse, Alyssa Stephenson-Famy
BACKGROUND : Little is known about the factors that influence medical student selection of obstetrics and gynecology (ob-gyn) residency programs. OBJECTIVE : We assessed the factors influencing residency program selection by fourth-year medical students pursuing ob-gyn training. METHODS : A voluntary, anonymous, 19-question survey of residency selection factors was distributed to all fourth-year medical students interviewing at 1 of 5 academic ob-gyn departments for a residency position during the 2013-2014 interview season...
February 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28258304/orthopaedic-trauma-surgeons-and-direct-anterior-total-hip-arthroplasty-evaluation-of-learning-curve-at-a-level-i-academic-institution
#6
Philip J York, Stephanie L Logterman, David J Hak, Andreas Mavrogenis, Cyril Mauffrey
BACKGROUND: Interest in the direct anterior approach for total hip arthroplasty has increased over recent years; however, the potential for substantial complications exists, especially during the surgeon's learning curve. We evaluated the change in various metrics to help identify a single surgeon's learning curve. Additionally, we examined whether the learning curve was different for primarily arthroplasty versus trauma-trained surgeons. METHODS: We reported outcomes from the first 50 total hip arthroplasties performed through a direct anterior approach by a trauma fellowship-trained orthopaedic surgeon...
March 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28242169/an-analysis-of-future-publications-career-choices-and-practice-characteristics-of-research-presenters-at-an-american-college-of-surgeons-state-conference-a-15-year-review
#7
Humera F Ahmad, Benjamin T Jarman, Kara J Kallies, Stephen B Shapiro
OBJECTIVES: The Accreditation Council for Graduate Medical Education requires scholarly activity within general surgery residency programs. The association between in-training research presentations and postgraduation publications is unknown. We hypothesized that surgical trainee presentations at an American College of Surgeons (ACS) state chapter meeting resulted in peer-reviewed publications and future scholarly activity. DESIGN: The ACS Wisconsin state chapter meeting agendas from 2000 to 2014 were reviewed to identify all trainees who delivered podium presentations...
February 24, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28236015/impact-of-continuous-training-through-distributed-practice-for-acquisition-of-minimally-invasive-surgical-skills
#8
Bruce Negrello Nakata, Worens Cavalini, Eduardo A Bonin, Paolo R Salvalaggio, Marcelo P Loureiro
BACKGROUND: Minimally invasive surgery (MIS) requires the mastery of manual skills and a specific training is required. Apart from residencies and fellowships in MIS, other learning opportunities utilize massive training, mainly with use of simulators in short courses. A long-term postgraduate course represents an opportunity to learn through training using distributed practice. OBJECTIVE: The objective of this study is to assess the use of distributed practice for acquisition of basic minimally invasive skills in surgeons who participated in a long-term MIS postgraduate course...
February 24, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28210649/predictive-surgical-reasons-for-failure-after-coracoid-process-transfers
#9
Gregory Gasbarro, Juan Marcelo Giugale, Gilles Walch, Albert Lin
BACKGROUND: Recurrent anterior shoulder instability after coracoid process transfers may be caused by trauma, sports injury, or technical failure of the index procedure. Surgical techniques vary with regard to graft orientation and positioning and number of screws utilized for fixation. PURPOSE: To identify surgical and patient-related factors associated with failure, defined as the need for revision surgery. We hypothesized that failures will occur more commonly with single-screw fixation and graft malposition...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28195997/development-and-validation-of-the-cochlear-implant-surgical-competency-assessment-instrument
#10
Thomas Balkany, Kaming Lo, Howard Francis, Simon Angeli, Michael Novak, William Luxford, Rodney Lusk, Heather Strader
OBJECTIVE: We present a new instrument for evaluation of cochlear implant (CI) surgical skills and review its validation process. METHODS: An instrument to assess CI surgical competency incorporated results of structured surveys of comprehensiveness sent to 30 international CI experts and US trainees. One-hundred evaluations of 28 residents, fellows, and practicing CI surgeons were completed. Surgical skills were evaluated by four experienced neurotologists (two raters per subject) using two temporal bones per subject...
April 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28194513/clinical-use-of-mri-for-the-evaluation-of-acute-appendicitis-during-pregnancy
#11
Darshan Patel, Jordan Fingard, Sean Winters, Gavin Low
PURPOSE: The purpose of this study was to determine the diagnostic accuracy of MRI for detecting acute appendicitis in pregnancy in a multi-institution study involving general body MR readers with no specific expertise in MR imaging of the pregnant patient. METHODS: Retrospective review of MRI examinations on PACS in 42 pregnant patients was evaluated for acute right lower quadrant pain. Three fellowship-trained general body radiologists analyzed the MRI examinations in consensus and attempted to localize the appendix, assess for features of appendicitis, and exclude alternative etiologies for the right lower quadrant pain...
February 13, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28193322/geographic-distribution-of-trauma-burden-mortality-and-services-in-the-united-states-does-availability-correspond-to-patient-need
#12
Arturo J Rios-Diaz, David Metcalfe, Olubode A Olufajo, Cheryl K Zogg, Brian Yorkgitis, Mansher Singh, Adil H Haider, Ali Salim
BACKGROUND: The association between the need for trauma care and trauma services has not been characterized previously. We compared the distribution of trauma admissions with state-level availability of trauma centers (TCs), surgical critical care (SCC) providers, and SCC fellowships, and assessed the association between trauma care provision and state-level trauma mortality. STUDY DESIGN: We obtained 2013 state-level data on trauma admissions, TCs, SCC providers, SCC fellowship positions, per-capita income, population size, and age-adjusted mortality rates...
December 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28187805/the-history-of-neurocritical-care
#13
E F M Wijdicks
Critical care medicine came into sharp focus in the second part of the 20th century. The care of acutely ill neurologic patients in the USA may have originated in postoperative neurosurgical units, but for many years patients with neurocritical illness were admitted to intensive care units next to patients with general medical or surgical conditions. Neurologists may have had their first exposure to the complexity of neurocritical care during the poliomyelitis epidemics, but few were interested. Much later, the development of neurocritical care as a legitimate subspecialty was possible as a result of a new cadre of neurologists, with support by departments of neurosurgery and anesthesia, who appreciated their added knowledge and expertise in care of acute neurologic illness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28162864/use-of-computed-tomography-to-determine-perforation-in-patients-with-acute-appendicitis
#14
Cameron E Gaskill, Vlad V Simianu, Jonathan Carnell, Daniel S Hippe, Puneet Bhargava, David R Flum, Giana H Davidson
PURPOSE: Urgent appendectomy has long been the standard of care for acute appendicitis. Six randomized trials have demonstrated that antibiotics can safely treat appendicitis, but approximately 1 in 4 of these patients eventually requires appendectomy. Overall treatment success may be limited by complex disease including perforation. Patients׳ success on antibiotic therapy may depend on preoperative identification of complex disease on imaging. However, the effectiveness of computed tomography (CT) in differentiating complex disease including perforated from nonperforated appendicitis remains to be determined...
December 7, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28148332/what-s-new-in-graduate-medical-education
#15
Raquel G Hernandez
The development of new graduate medical education programmes provides both opportunities and challenges. Efforts to address physician workforce shortages as well as a realisation that curricula need to be updated to adjust to our rapidly changing healthcare environment have resulted in more educators considering the "how to" and "what's new" of programme development. Understanding the Next Accreditation System, an accreditation system introduced by the Accreditation Council of Graduate Medical Education in 2012, is critical to the success of new as well as existing residency and fellowship programmes...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28139387/the-influence-of-patient-and-surgeon-specific-factors-on-operative-duration-and-early-postoperative-outcomes-in-shoulder-arthroplasty
#16
Jonathan C Clark, Peter Simon, Rachel E Clark, Kaitlyn N Christmas, Jesse W Allert, Jonathan J Streit, Mark A Mighell, Alfred Hess, Jeffrey Stone, Mark A Frankle
BACKGROUND: Increased operative duration has been shown to have demonstrable effects on the outcomes and complications in multiple areas of orthopedic surgery. We sought to determine if patient- and surgeon-specific factors correlated to operative duration in shoulder arthroplasty. Our hypothesis was that increased surgeon and trainee volume would decrease operative times and that more complex pathology would increase operative duration. METHODS: A retrospective review of primary and revision total and reverse shoulder arthroplasties performed at a single institution from 2012 through 2015 was performed evaluating the correlation between specific patient and surgeon factors and operative duration...
January 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28124653/practice-patterns-in-pediatric-chronic-rhinosinusitis-a-survey-of-the-american-rhinologic-society
#17
Daniel M Beswick, Hassan Ramadan, Fuad M Baroody, Peter H Hwang
BACKGROUND: The management of pediatric chronic rhinosinusitis (PCRS) is evolving. OBJECTIVE: To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS. METHODS: A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership. RESULTS: The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%)...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28120274/advanced-gi-surgery-training-a-roadmap-for-the-future-the-white-paper-from-the-ssat-task-force-on-advanced-gi-surgery-training
#18
Matthew M Hutter, Kevin E Behrns, Nathaniel J Soper, Fabrizio Michelassi
There is the need for well-trained advanced GI surgeons. The super specialization seen in academic and large community centers may not be applicable for surgeons practicing in other settings. The pendulum that has been swinging toward narrow specialization is swinging the other way, as many trained subspecialists are having a harder time finding positions after fellowship, and if they do find a position, the majority of their practice can actually be advanced GI surgery and not exclusively their area of focused expertise...
January 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28119483/early-menarche-nulliparity-and-the-risk-for-premature-and-early-natural-menopause
#19
Gita D Mishra, Nirmala Pandeya, Annette J Dobson, Hsin-Fang Chung, Debra Anderson, Diana Kuh, Sven Sandin, Graham G Giles, Fiona Bruinsma, Kunihiko Hayashi, Jung Su Lee, Hideki Mizunuma, Janet E Cade, Victoria Burley, Darren C Greenwood, Alissa Goodman, Mette Kildevæld Simonsen, Hans-Olov Adami, Panayotes Demakakos, Elisabete Weiderpass
STUDY QUESTION: Are parity and the timing of menarche associated with premature and early natural menopause? SUMMARY ANSWER: Early menarche (≤11 years) is a risk factor for both premature menopause (final menstrual period, FMP <40 years) and early menopause (FMP 40-44 years), a risk that is amplified for nulliparous women. WHAT IS KNOWN ALREADY: Women with either premature or early menopause face an increased risk of chronic conditions in later life and of early death...
January 24, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28098706/current-trends-in-ulnar-collateral-ligament-reconstruction-surgery-among-newly-trained-orthopaedic-surgeons
#20
Ryan M Degen, Christopher L Camp, Johnathan A Bernard, David M Dines, David W Altchek, Joshua S Dines
INTRODUCTION: Ulnar collateral ligament (UCL) reconstructions are being performed with an increasing annual incidence. The purpose of this study was to evaluate trends in UCL surgery among recently trained orthopaedic surgeons. METHODS: The American Board of Orthopaedic Surgeons (ABOS) database was used to identify all UCL reconstructions from 2004 to 2013. Procedures were identified by Current Procedural Terminology (CPT) codes and verified by International Classification of Disease, Ninth Revision (ICD-9) codes...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
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