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https://www.readbyqxmd.com/read/28210649/predictive-surgical-reasons-for-failure-after-coracoid-process-transfers
#1
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
#2
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...
February 10, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28194513/clinical-use-of-mri-for-the-evaluation-of-acute-appendicitis-during-pregnancy
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28066603/characteristics-of-cardiothoracic-surgeons-practicing-at-the-top-ranked-us-institutions
#13
Carlo Maria Rosati, Leonidas G Koniaris, Daniela Molena, David Blitzer, Katherine W Su, Mohammad Tahboub, Panos N Vardas, Leonard N Girardi, Mario Gaudino
BACKGROUND: We aimed to determine which factors distinguish cardiothoracic (CT) surgeons practicing at the top-ranked US institutions from their peers. METHODS: Using online resources, we collected demographics, training information and academic metrics of 694 cardiac (n=489; 70%) and thoracic (n=205; 30%) surgeons practicing at 57 preeminent US institutions, including those with the highest US News & World Report ranking ("top CT centers"). RESULTS: Two hundred and ninety-nine (43...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28050201/neck-dissection-technique-commonality-and-variance-a-survey-on-neck-dissection-technique-preferences-among-head-and-neck-oncologic-surgeons-in-the-american-head-and-neck-society
#14
Shirin M Hemmat, Steven J Wang, William R Ryan
Introduction Neck dissection (ND) technique preferences are not well reported. Objective The objective of this study is to educate practitioners and trainees about surgical technique commonality and variance used by head and neck oncologic surgeons when performing a ND. Methods Online survey of surgeon members of the American Head and Neck Society (AHNS). Survey investigated respondents' demographic information, degree of surgical experience, ND technique preferences. Results In our study, 283 out of 1,010 (28%) AHNS surgeon members with a mean age of 50...
January 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/28029534/the-influence-of-fellowship-training-on-the-practice-of-pancreatoduodenectomy
#15
Gregory T Kennedy, Matthew T McMillan, Michael H Sprys, Claudio Bassi, Paul D Greig, Paul D Hansen, Dhiresh R Jeyarajah, Tara S Kent, Giuseppe Malleo, Giovanni Marchegiani, Rebecca M Minter, Charles M Vollmer
BACKGROUND: There has been a proliferation of gastrointestinal surgical fellowships; however, little is known regarding their association with surgical volume and management approaches. METHODS: Surveys were distributed to members of GI surgical societies. Responses were evaluated to define relationships between fellowship training and surgical practice with pancreatoduodenectomy (PD). RESULTS: Surveys were completed by 889 surgeons, 84.1% of whom had completed fellowship training...
October 28, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28029219/defining-the-tipping-point-in-surgical-performance-for-laparoscopic-donor-nephrectomy-among-transplant-surgery-fellows-a-risk-adjusted-cumulative-summation-learning-curve-analysis
#16
O K Serrano, A S Bangdiwala, D M Vock, D Berglund, T B Dunn, E B Finger, T L Pruett, A J Matas, R Kandaswamy
The United Network for Organ Sharing recommends that fellowship-trained surgeons participate in 15 laparoscopic donor nephrectomy (LDN) procedures to be considered proficient. The American Society of Transplant Surgeons (ASTS) mandates 12 LDNs during an abdominal transplant surgery fellowship. We performed a retrospective intraoperative case analysis to create a risk-adjusted cumulative summation (RACUSUM) model to assess the learning curve of novice transplant surgery fellows (TSFs). Between January 2000 and December 2014, 30 novice TSFs participated in the organ procurement rotation of our ASTS-approved abdominal transplant surgery fellowship...
December 28, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/28027845/differences-in-the-treatment-of-distal-radius-fractures-by-hand-fellowship-trained-surgeons-a-study-of-abos-candidate-data
#17
Sean Childs, Tobias Mann, Jason Dahl, John Ketz, Warren C Hammert, Peter M Murray, John Elfar
PURPOSE: The management of distal radius fractures differs based on the nature of the fracture and the experience of the surgeon. We hypothesized that patients requiring surgical intervention would undergo different procedures when in the care of a surgeon with subspecialty training in hand surgery as compared with surgeons with no subspecialty training in hand surgery. METHODS: We queried the ABOS database for case log information submitted for part II of the ABOS examination...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28019023/academic-productivity-of-faculty-associated-with-microsurgery-fellowships
#18
Qing Zhao Ruan, Joseph A Ricci, Jason Silvestre, Olivia A Ho, Bernard T Lee
BACKGROUND: The Hirsch index (h-index) is widely recognized as a reliable measure of academic productivity. While previous studies have applied the h-index to surgical disciplines, none have analyzed microsurgery faculty. This manuscript aims to examine the h-index of microsurgery fellowship faculty to categorize its applicability to microsurgeons as a determinant of academic output. METHODS: Faculty demographics and institution characteristics were obtained from the American Society of Reconstructive Microsurgery (ASRM) and official program websites...
December 26, 2016: Microsurgery
https://www.readbyqxmd.com/read/28017413/endangered-academia-preserving-the-pediatric-surgeon-scientist
#19
Troy A Markel, Nakul P Valsangkar, Teresa M Bell, Brandon A Kiel, Teresa A Zimmers, Leonidas G Koniaris
BACKGROUND: Pediatric surgery is one of the most difficult surgical fellowships to obtain. It requires stellar academic credentials and, often, dedicated time pursuing research. It is unknown, however, if pediatric surgeons maintain high academic output as faculty members. We hypothesized that the majority of pediatric surgeons do not pursue robust research activities as faculty, and therefore, over time, their academic productivity decreases. METHODS: Numbers of publications, citations, H-index, and NIH funding rates were determined for 4354 surgical faculty at the top-55 NIH based departments of surgery using websites, Scopus, NIH RePORTER, and Grantome...
December 20, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28007068/congenital-heart-surgery-subspecialty-certification-how-is-it-working-the-american-board-of-thoracic-surgery-perspective
#20
REVIEW
James S Tweddell
Congenital heart surgery is among the most challenging fields in all of medicine. The unique skills and knowledge base required prompted the American Board of Thoracic Surgery (ABTS) to establish the Subspecialty Certificate in Congenital Heart Surgery (CHS). Standards for operative experience and fellowship training programs were established by the ABTS and the Accreditation Council for Graduate Medical Education. Since 2009, 188 Subspecialty Certificates in CHS have been granted, including 38 earned through the fellowship training pathway...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
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