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https://www.readbyqxmd.com/read/28108068/challenges-training-left-handed-surgeons
#1
Maia Anderson, Erica Carballo, David Hughes, Christopher Behrer, Rishindra M Reddy
BACKGROUND: Being left-handed (LH) is considered a disadvantage in surgical training. We sought to understand the perspectives of LH trainees and surgical educators on the challenges and modifications in training LH surgeons. METHODS: A survey was distributed to surgeons, surgical residents, and medical students about challenges teaching and learning surgical technique. RESULTS: 25 LH surgeons, 65 right-handed (RH) surgeons, and 39 LH trainees completed the survey...
December 31, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28106647/estimation-of-uterine-size-how-accurate-are-we
#2
Tanya P Hoke, Babak Vakili
OBJECTIVE: To evaluate the accuracy of gynecologic surgeons at estimating uterine dimensions and weight. METHODS: Six model uteri of various sizes were created to simulate the size and consistency of a uterus and displayed at 3 stations. The visual station (VS) comprised 2 specimens placed on an unmarked table. The laparoscopic station (LS) consisted of 2 model uteri, each placed in a separate simulated abdomen with a 0 degree laparoscope and 2 operative trocars with standard instruments...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28105620/-effect-of-a-clinical-pathway-in-patients-with-crohn-s-disease-complicated-with-intestinal-obstruction
#3
Zhen Guo, Lei Cao, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction. METHODS: CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28101477/change-of-patient-selection-strategy-and-improved-surgical-outcome-in-mri-negative-neocortical-epilepsy
#4
Hye-Jin Moon, Dong Wook Kim, Chun-Kee Chung, Jung-Won Shin, Jangsup Moon, Bong Su Kang, Soon-Tae Lee, Keun-Hwa Jung, Kon Chu, Ki-Young Jung, Yong Won Cho, Sang Kun Lee
BACKGROUND AND PURPOSE: It is crucial to make selection strategy to identify surgical candidates among medically refractory MRI-negative neocortical epilepsy patients. In our previous study, we suggested two or more concordance between noninvasive studies (EEG, ictal scalp EEG, interictal FDG-PET, and SPECT) as a new patient selection strategy for MRI-negative neocortical epilepsy surgery. The objective of this study was to evaluate the surgical outcomes of MRI-negative neocortical epilepsy patients before and after the implementation of a new selection strategy...
December 2016: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/28100427/the-possible-role-of-propofol-in-drug-induced-torsades-de-pointes-a-real-world-single-center-analysis
#5
Victor A Abrich, Harish Ramakrishna, Arjun Mehta, Farouk Mookadam, Komandoor Srivathsan
BACKGROUND: Torsades de pointes (TdP) is a polymorphic ventricular tachycardia associated with QT prolongation. Propofol is a sedative-anesthetic with proarrhythmic effects on cardiac myocytes. We performed a retrospective study to determine the incidence of TdP following propofol exposure at Mayo Clinic (Rochester, MN) from 08/11/1998-11/20/2015. METHODS: We queried our database using key search terms to identify patients exposed to propofol who developed TdP perioperatively or during non-surgical sedation...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28097296/long-term-postprocedural-outcomes-of-palliative-emergency-stenting-vs-stoma-in-malignant-large-bowel-obstruction
#6
Jonathan S Abelson, Heather L Yeo, Jialin Mao, Jeffrey W Milsom, Art Sedrakyan
Importance: Colonic stenting was introduced for palliation of malignant large-bowel obstruction (MLBO) more than 20 years ago but remains controversial. Objective: To compare outcomes after palliative stenting vs stoma creation in patients with MLBO requiring emergency management. Design, Setting, and Participants: This observational cohort study assessed 345 patients from New York State with an urgent or emergency admission to the hospital for obstruction secondary to colorectal cancer and who underwent stenting or stoma creation from October 1, 2009, through December 31, 2013...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28093346/impact-of-obesity-on-complications-and-30-day-readmission-rates-after-cranial-surgery-a-single-institutional-study-of-224-consecutive-craniotomy-craniectomy-procedures
#7
Amanda Sergesketter, Aladine A Elsamadicy, Oren N Gottfried
BACKGROUND: the prevalence of obesity is growing at a disparaging rate in the United States. While prior studies have associated obesity with increased surgical complications and readmission rates, the impact of obesity on surgical outcomes after cranial surgery remains understudied. The aim of this study is to assess the effect obesity has on complication and 30-day readmission rates after cranial surgery. METHODS: The medical records of 224 (Non-Obese: n=164, Obese: n=60) consecutive patients undergoing either craniotomy or craniectomy at a major academic institution in 2011 were reviewed...
January 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28093118/surgical-fires-and-operative-burns-lessons-learned-from-a-33-year-review-of-medical-litigation
#8
Asad J Choudhry, Nadeem N Haddad, Mohammad A Khasawneh, Daniel C Cullinane, Martin D Zielinski
OBJECTIVE: We aimed to understand the setting and litigation outcomes of surgical fires and operative burns. METHODS: Westlaw, an online legal research data-set, was utilized. Data were collected on patient, procedure, and case characteristics. RESULTS: One hundred thirty-nine cases were identified; 114 (82%) operative burns and 25 (18%) surgical fires. Median plaintiff (patient) age was 46 (IQR:28-59). Most common site of operative burn was the face (26% [n = 36])...
December 12, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#9
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28090345/electronically-captured-patient-reported-physical-function-an-important-vital-sign-in-obesity-medicine
#10
J Fleming, G C Wood, C Seiler, A Cook, M R Lent, C D Still, P N Benotti, B A Irving
OBJECTIVES: Impaired physical function (i.e., inability to walk 200 feet, climb a flight of stairs or perform activities of daily living) predicts poor clinical outcomes and adversely impacts medical and surgical weight management. However, routine assessment physical function is seldom performed clinically. The PROMIS Physical Function Short Form 20a (SF-20a) is a validated questionnaire for assessing patient reported physical function, which includes published T-score percentiles adjusted for gender, age and education...
December 2016: Obesity Science & Practice
https://www.readbyqxmd.com/read/28089473/box-or-virtual-reality-trainer-which-tool-results-in-better-transfer-of-laparoscopic-basic-skills-a-prospective-randomized-trial
#11
Christian Brinkmann, Mathias Fritz, Ulrich Pankratius, Ralf Bahde, Philipp Neumann, Steffen Schlueter, Norbert Senninger, Emile Rijcken
OBJECTIVE: Simulation training improves laparoscopic performance. Laparoscopic basic skills can be learned in simulators as box- or virtual-reality (VR) trainers. However, there is no clear recommendation for either box or VR trainers as the most appropriate tool for the transfer of acquired laparoscopic basic skills into a surgical procedure. DESIGN: Both training tools were compared, using validated and well-established curricula in the acquirement of basic skills, in a prospective randomized trial in a 5-day structured laparoscopic training course...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28087823/prognosis-of-carotid-dissecting-aneurysms-results-from-cadiss-and-a-systematic-review
#12
Susanna C Larsson, Alice King, Jeremy Madigan, Christopher Levi, John W Norris, Hugh S Markus
OBJECTIVE: To determine the natural history of dissecting aneurysm (DA) and whether DA is associated with an increased recurrent stroke risk and whether type of antithrombotic drugs (antiplatelets vs anticoagulants) modifies the persistence or development of DA. METHODS: We included 264 patients with extracranial cervical artery dissection (CAD) from the Cervical Artery Dissection in Stroke Study (CADISS), a multicenter prospective study that compared antiplatelet with anticoagulation therapy...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28079861/endoscopic-vs-surgical-interventions-for-painful-chronic-pancreatitis-what-is-needed-for-future-clinical-trials
#13
REVIEW
John A Windsor, Nageshwar D Reddy
The treatment of painful chronic pancreatitis remains controversial. The available evidence from two randomized controlled trials favor surgical intervention, whereas an endotherapy-first approach is widely practiced. Chronic pancreatitis is complex disease with different genetic and environmental factors, different pain mechanisms and different treatment modalities including medical, endoscopic, and surgical. The widely practiced step-up approach remains unproven. In designing future clinical trials there are some important pre-requisites including a more comprehensive pain assessment tool, the optimization of conservative medical treatment and interventional techniques...
January 12, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28079682/comparing-short-term-complications-of-inpatient-versus-outpatient-single-level-anterior-cervical-discectomy-and-fusion-an-analysis-of-6940-patients-using-the-acs-nsqip-database
#14
Ryan Khanna, Robert B Kim, Sandi K Lam, George R Cybulski, Zachary A Smith, Nader S Dahdaleh
STUDY DESIGN: Multicenter propensity score-adjusted retrospective cohort study. OBJECTIVE: To determine baseline 30-day complication rates for anterior cervical discectomy and fusion (ACDF) and compare clinical complications for patients undergoing single-level ACDFs between inpatient and outpatient settings. SUMMARY OF BACKGROUND DATA: ACDF remains the most common procedure in the treatment of a variety of cervical disc pathologies, making it a focus of quality improvement initiatives...
January 10, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28078135/investigating-the-prognostic-value-of-koc-k-homology-domain-containing-protein-overexpressed-in-cancer-overexpression-after-curative-intent-resection-of-pancreatic-ductal-adenocarcinoma
#15
Benny Johnson, Maged Khalil, Joseph Blansfield, Fan Lin, Shaobo Zhu, H Lester Kirchner, Alva B Weir
BACKGROUND: Pancreatic adenocarcinoma (PDAC) is now the third leading cause of cancer mortality in the United States. More than 80% of patients present with distant metastasis precluding surgical eligibility. Even among patients with localized disease deemed eligible for surgical resection, the median survival is only 22.8 months due to high recurrence rates. Identification of a biomarker correlated with patient specific prognosis upon initial diagnosis can serve as a way to individualize treatment options...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28077026/a-case-control-study-of-risk-factors-of-chronic-venous-ulceration-in-patients-with-varicose-veins
#16
Gohar Abelyan, Lusine Abrahamyan, Gayane Yenokyan
Background/objectives Venous ulcers carry psychological and high financial burden for patients, causing depression, pain, and limitation of mobility. The study aimed to identify factors associated with an increased risk of venous ulceration in patients with varicose veins in Armenia. Methods A case-control study design was utilized enrolling 80 patients in each group, who underwent varicose treatment surgery in two specialized surgical centers in Armenia during 2013-2014 years. Cases were patients with varicose veins and venous leg ulcers...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#17
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28073573/surgery-for-predominant-lesion-in-nonlocalized-bronchiectasis
#18
Jie Dai, Xinsheng Zhu, Dongliang Bian, Ke Fei, Gening Jiang, Peng Zhang
OBJECTIVE: Patients with nonlocalized bronchiectasis are encountered commonly; however, there is little information regarding surgical intervention in this patient population. The aim of this study was to evaluate symptomatic response and safety of anatomic resection of the predominant lesion via the use of lobectomy for the management of nonlocalized bronchiectasis. METHODS: We reviewed the medical records of 37 consecutive patients who underwent lobectomy via thoracotomy for nonlocalized bronchiectasis between 2010 and 2013...
December 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28072666/outcomes-from-referrals-and-unscheduled-visits-from-community-emergency-departments-to-a-regional-pediatric-emergency-department-in-canada
#19
Ethan Reiner, Ardalan Ahmadi, Eric Grafstein, Quynh Doan
OBJECTIVES: Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care. METHODS: We conducted a retrospective cohort study reviewing all pediatric visits (age < 17 y) at 5 GEDs in Vancouver...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28072654/adverse-events-following-vestibular-schwannoma-surgery-a-comparison-of-surgical-approach
#20
Anthony M Tolisano, Philip D Littlefield
OBJECTIVE: Compare complications of vestibular schwannoma (VS) resection by surgical approach. STUDY DESIGN: Retrospective cohort. SETTING: The 2008 to 2013 American College of Surgeons-National Surgical Quality Improvement Program. PATIENTS: Adult patients with VS resection by an otolaryngologist. INTERVENTIONS: VS resection via transtemporal (TT), retrosigmoid (RS), or middle cranial fossa (MCF) approaches...
January 9, 2017: Otology & Neurotology
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